We usually reduce the size of areola (darker skin around the nipple) as a part of breast reduction or breast liftprocedure, 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.
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. 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.
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.