Nipple and Areolar Correction Plastic Surgeon Wollongong & Sydney

Areola reduction decreases the diameter of an enlarged, widened or stretched areola. It may be considered when the areolae have always been large or have changed following pregnancy, breastfeeding, weight change or breast surgery.

During the procedure, the surgeon removes a circular section of skin from around the outside of the areola. The surrounding breast skin is then brought inward.

The resulting scar sits around the areola border. It is usually more noticeable during early healing and generally softens with time, although the final appearance varies.

The tissues remain exposed to tension, ageing and future breast changes. For this reason, some widening or stretching of the areola can recur.

Nipple reduction may be considered when a nipple is longer, wider or more prominent than preferred. The procedure can reduce nipple height, width or both.

The technique and scar position depend on the nipple’s shape and the degree of reduction required.

Because surgery involves the nipple itself, it may affect sensation and breastfeeding. Discuss future pregnancy and feeding plans before deciding whether to proceed.

Minor differences between the nipples and areolae are normal. More noticeable asymmetry can be present from breast development or develop following pregnancy, breastfeeding, weight change or previous surgery.

Depending on the cause, treatment may adjust:

• Nipple projection
• Nipple length or width
• Areola diameter
• Areola shape
• Nipple or areola position.

If the difference is mainly caused by breast volume, skin or shape, correcting the nipple or areola alone may not address the whole concern. Breast lifting, reduction, augmentation or fat transfer may also be considered.

Surgery may improve balance, but perfect symmetry cannot be guaranteed.

As with any surgery, bleeding, infection and delayed wound healing can occur. Bleeding may cause a blood collection (haematoma) that needs draining, and an infection may require antibiotics or, occasionally, further treatment. Smoking and nicotine use can slow healing.

The anaesthetic used depends on the procedure. Local anaesthetic can cause temporary discomfort or, rarely, a reaction to the medicine. Sedation and general anaesthesia carry their own risks, including reactions to medicines and breathing or heart problems. When general anaesthesia is used, or the correction is combined with other breast surgery, blood clots can form in the deep veins of the legs (deep vein thrombosis) and may travel to the lungs (pulmonary embolism), which can be life-threatening.

Nipple sensation may increase, decrease or change after surgery. These changes are often temporary, but in some patients they are permanent, and the two sides may recover differently.

The nipple and areola rely on a delicate blood supply. If it is reduced, part or all of the nipple or areola may heal poorly or not survive. This is more likely when the correction is combined with a breast lift, reduction or revision, or after previous breast surgery, and may require prolonged wound care or further surgery.

Some procedures, particularly correction of a more fixed inverted nipple or nipple reduction, may divide or affect the milk ducts. This can reduce or prevent the ability to breastfeed. If future breastfeeding is important to you, discuss this before surgery.

The nipples and areolae may heal with differences in size, shape, projection or position. A corrected nipple can sometimes appear flatter than expected, and perfect symmetry cannot be guaranteed.

Scars around the areola or on the nipple usually soften and fade with time, but they can widen, stretch, become raised or differ in colour from the surrounding skin.

Nipple inversion can recur as the tissues heal, and an areola can stretch again over time, particularly with pregnancy, weight change or ageing. Further treatment or surgery may occasionally be needed.

Depending on the procedure, breastfeeding may also be affected. The considerations relevant to your proposed operation will be explained during consultation and through the formal informed-consent process.