Nipple Reduction

Nipple reduction is a cosmetic surgical procedure wherein the projection or areola width of a patient’s nipple is reduced by removing excess skin. This surgery is performed to correct nipple hypertrophy or enlarged areola that can result in an overly prominent nipple-areola complex. This can lead to embarrassment for the patient as well as discomfort in certain types of clothing. 

Dr. Michael Zarrabi is a board-certified plastic surgeon serving the Beverly Hills and Santa Monica areas of California. At Zarrabi Plastic Surgery, he performs personalized procedures for a wide variety of patients, specializing in all aspects of plastic surgery. If you are self-conscious about the size or contour of your nipples, schedule a consultation with Dr. Zarrabi today by filling out our contact form or calling us at (310) 584-9990.

All About Nipple Reduction Surgery 

Nipple Hypertrophy and Reduction Techniques

In patients with nipple hypertrophy, the nipple is long, extending past certain social standards and expectations. It is commonly seen in women and can cause severe psychological damage, especially during a patient’s teenage years. The nipple protrudes, often with a bulbous effect, and the width of the total nipple-areola complex is often extensive as well.

There is currently no “gold standard” technique to reduce nipple projection and length, resulting in different types of procedure plans. In a study observing “normal” or socially accepted nipple projection, it was found that the ideal nipple ratio should be less than 10 mm in diameter and 2 mm in projection (height). Patients with nipple hypertrophy or macrothelia (enlarged nipples) can experience up to 2 cm of projection. When this area is elongated, patients often experience psychosocial issues and distress. ⁽¹⁾

The authors of an article published in 2019 observed that there are five commonly performed techniques to correct elongated nipples: ⁽¹⁾

The technique chosen by Dr. Zarrabi is determined by each patient’s nipple projection, areola shape, and other physical aspects. Some of the techniques aim to preserve the duct system, and some are more focused on aesthetic outcomes. For instance, the flap technique has proven to preserve the ductal system and allow for both height and width reduction, but the method is complex and leaves the patient with visible scars. ⁽¹⁾ Dr. Zarrabi will inquire about your cosmetic goals and concerns during your private consultation to determine what method will work best for you. 

Enlarged Areola

Surgical techniques for areola reduction are similar to those used to reduce nipple projection. Dr. Zarrabi uses a circular surgical tool to measure out a smaller areola during surgery. The nipple is carefully trimmed without impacting the internal duct system, and the structure is kept whole.

During a breast lift or breast reduction, this step is integral in achieving an improved nipple shape and size that compliments the resulting breast shape. Excess skin is removed from around the edge of the nipple-areola complex. Dr. Zarrabi then sutures the surrounding skin around the new nipple shape to create an improved contour and lift. ⁽²⁾

How Can I Benefit From Nipple Reduction?

A nipple reduction procedure has many benefits, including:

Nipple reduction surgery often greatly reduces a patient’s anxiety and negative self-image. The surgery can be easily combined with other breast procedures or performed on its own.

Ideal Candidates

Nipple reduction is suitable for patients who have elongated nipples and wide or stretched areola. You must first and foremost be in overall good health with no underlying conditions. Your surgical expectations should be reasonable. Female patients should wait until they are done bearing children before they undergo this procedure since it may impact the ability to breastfeed. The act of breastfeeding itself can also alter the nipple-areola complex after surgery, often negatively impacting the shape. 

Personal Consultation

During your private consultation, Dr. Zarrabi will examine the treatment area to determine your candidacy and overall health. He will inquire about your medical history and any past procedures that may impact your results. Dr. Zarrabi will explain the surgery in great detail to make sure you are educated and prepared. You will undergo all necessary blood tests to ensure you are healthy before scheduling your procedure.

Preparation

To best prepare yourself for nipple reduction surgery, please refrain from tobacco and nicotine usage and alcohol consumption. Dr. Zarrabi may suggest medication alterations and suggest alternatives that will not impact your ability to heal. Avoid the use of anti-inflammatories like ibuprofen as they increase your risk of bleeding. 

Schedule time off of work and pick up any prescriptions that Dr. Zarrabi writes before your procedure date. We require that you have a trusted person available to transport you to and from our surgical center.

Nipple Reduction Procedure

Depending on the patient, Dr. Zarrabi performs nipple reduction surgery with the use of general or local anesthesia. After the treatment area is numb and you are comfortable, he makes his incisions according to your personal treatment plan. When performed on its own, nipple reduction is a simple and relatively quick procedure. Once the appropriate amount of skin is removed, Dr. Zarrabi sutures the nipple-areola complex together following the breast’s natural contours to help conceal scarring. He then protects the treatment area with surgical wrapping or a compression garment. The procedure typically takes around 1 hour to complete.

Recovery & Results

Patients usually experience moderate swelling and bruising around the nipple for several days following this procedure. You may take over-the-counter medications like Tylenol to keep you comfortable if you are not prescribed anything by Dr. Zarrabi. You may take 2 to 3 days off of work depending on how you are feeling. Refrain from any vigorous physical and sexual activity for at least 1 postoperative week to allow your incisions to properly heal.

After the procedure, your nipples will be smaller and circular in a more flattened position against the breast. The swelling may obstruct your results for the first 2 or 3 weeks, but you can notice subtle changes as you heal. Your final results may take around a month to be apparent.

Corresponding & Complementary Procedures 

Breast Augmentation

Dr. Zarrabi performs many breast augmentations for patients looking to increase the size of their chest. He makes an incision either along the areola, or along the breast fold, or a combination of all three to access the anatomy underneath the skin. After creating a breast pocket above or beneath the pectoral muscle, he places a breast implant to add volume and structure. Dr. Zarrabi then sutures the breast in layers to ensure the structure is sound and the implant stays in place.

Breast Lift

During a breast lift procedure, skin and breast tissue are removed from the bottom pole of the breast. Dr. Zarrabi measures and stamps the correct nipple size before making an incision around the areola and down toward the breast fold. He then removes excess skin, repositions the nipple, and closes his incisions. Unlike a breast augmentation, a breast lift does not increase the size of the breasts. The procedure’s intention is to lift and reposition the nipple and breast tissue for a more youthful breast contour. 

Both procedures often include nipple reduction. They are customizable and frequently performed together to achieve an optimal cosmetic result.

How Much Does Nipple Reduction Cost in Beverly Hills?

The cost of nipple reduction surgery is completely dependent on each patient’s specific treatment plan. Your price breakdown is determined by Dr. Zarrabi during your initial consultation. A combination of surgeries, like a breast augmentation with nipple reduction, will result in a different cost than a nipple reduction on its own. To learn more about the procedure and whether you are a good candidate, call Zarrabi Plastic Surgery directly at (310) 584-9990 to schedule your first appointment. 

FAQ

References

1. Trøstrup H, Saltvig I, Matzen SH. Current surgical techniques for nipple reduction: A literature review. JPRAS Open. 2019;21:48-55. doi:https://doi.org/10.1016/j.jpra.2019.06.002
2. Paolini G, Firmani G, Briganti F, Michail Sorotos, Fabio. Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm. Aesthetic Plastic Surgery. 2021;45(3):933-945. doi:https://doi.org/10.1007/s00266-020-02047-9