Correction of inverted or enlarged nipples, reduction of areolas, reconstruction of nipples and areolas
- reduction of the areolas (dark pigmented skin around the nipple)
- correction of inverted or enlarged nipples
- reconstruction of NAC – nipple areolar complex after mastectomy
- procedures are done on an outpatient basis
- short 20-30 minute operations in local anesthesia
- you can take a shower and get back to normal activities within a few days
- the scars are not usually prominent and will fade with time
- stitches will dissolve and there is no need to remove them
What is nipple and areola reduction?
We usually reduce the size of areola (darker skin around the nipple) as a part of breast reduction or breast lift procedure, but it can also be done as separate operation under local anesthesia on an outpatient basis. If the nipple is enlarged or elongated, it can also be corrected. There are several techniques to achieve an aesthetically pleasing nipple. Nipple sensation and ability to breast-feed after the operation depend on the chosen method and should normally be preserved. If pregnancies are planned, it is best to wait with nipple reduction surgery until nursing is finished.
Can inverted nipples be corrected?
Women with inverted nipples can have problems with breast feeding or erogenous sensation. Sometimes women notice their nipples became inverted after they have finished nursing.
There are three degrees of inversion – which basically means three levels of severity. While some nipples may only be inverted some of the time (and “come out” or become everted in response to cold or physical touch), others are more severely inverted and never come out. Some women can breastfeed normally, while others will never be able to breastfeed.
- Grade 1. Nipples are inverted but can become everted manually (through stimulation) or in response to cold temperature. They can remain everted for some time. Milk ducts are usually not compromised and breast feeding is possible.
- Grade 2. Nipples are inverted and are more difficult to evert. The eversion almost never lasts – the nipple returns to the inverted state immediately. Breast feeding could be possible, but this is not a sure thing.
- Grade 3. Nipples are severely inverted and never evert. Milk ducts are often constricted and breast feeding is impossible. Women with Grade 3 inverted nipples may also struggle with infections, rashes, or problems with nipple hygiene.
Inverted nipple correction will improve the projection and appearance of the nipples. During inverted nipple surgery, the tight bands that connect the glandular tissue and the nipple base have to be released. To achieve a good and long-lasting result the ability to breast-feed is sometimes compromised as milk ducts have to be severed to release the inverted nipple. The procedure is done under local anesthesia on an outpatient basis. After surgery, we apply a special dressing that protects the nipple for a week.
How are nipple and areola reconstruction after mastectomy performed?
Breast reconstructive procedures involve not only the reconstruction of the breast mound, but recreation of the nipple and areola. We reconstruct the nipple and areola approximately six months out of breast reconstruction to allow the breast to assume its final contour. The reconstructed nipple will not have erogenous sensation, but its creation completes the reconstruction and is always recommended. We perform the procedure on an outpatient basis, with local anesthetic.
New nipple can be created from local tissues or with nipple sharing. The latter can be used when the remaining nipple is large enough to allow a piece of it to be transplanted to the reconstructed breast. Whatever method used, the reconstructed nipple tends to contract and flatten with time.
For the areola, a medical tattoo is used to create an areola circle. Special pigments are selected to match the color hues appearing on the healthy side. The tattoo may fade with time and a touch up may be required.
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