Inverted, Large or "Puffy" Nipple/Areola Repair

In the Puget Sound Area and around the country, there is a lot of media attention given to breast enhancement; breast reduction and breast lift (mastopexy) surgery. Few realize that isolated problems of the nipples and areolas can also be corrected. What most people refer to as a nipple actually has two components: the central part that normally protrudes (the nipple) and the flatter, disk-shaped darker colored portion (the areola). The nipple and areola together constitute one of the most important cosmetic units of the breast and problems in this area can be a source of significant unhappiness for some people. Some common problems of the nipple and areola include inverted nipples, excessively large areolas or protruding ("puffy") areolas.

Inverted nipples (inward pointing) are actually fairly common. This problem occurs in as many as 2% of women and can affect one or both sides. Inverted nipples can result from a narrow nipple base, excessively short milk ducts or by scarring of the milk ducts (after a milk duct infection). There are various degrees of nipple inversion, graded by severity. In the mildest form (grade 1), nipples tend to invert when stimulated by cold or touch but are usually in the normal position. In the moderate form (grade 2), the nipples are usually inverted but can be pushed out with manual pressure. In the severe form (grade 3), no amount of squeezing can correct the inversion. Breast-feeding can be a problem with the moderate to severe cases and many women feel very self-conscious of their inverted nipples regardless of the severity.

At Pearl Plastic Surgery, inverted nipples can be corrected as its own procedure or as part of another breast surgery. This surgery involves exposing and selectively dividing whatever is pulling the nipple inward, while leaving any healthy milk ducts intact. In most cases, depending on the severity, the ability to breast-feed is preserved. The recovery period from this surgery is relatively short, while the functional and self-esteem benefits are significant.

Large Areolas: There is no perfect areola size, as everyone has his or her own sense of what looks best. Despite this, many women still feel that their areolas are too large. Sometimes, large areolas are associated with large breasts, in which case both can be corrected simultaneously with a breast reduction or a breast lift. However, in women who are happy with their breast size but unhappy with their areola size, a relatively simple procedure can be performed to reduce the areola to a smaller, more aesthetic size. This procedure is an outpatient procedure and can be done at our office.

Protruding "Puffy" Areolas: Some women are embarrassed because they believe that their areolas are too "puffy". The skin of the areola is not as thick as the surrounding skin and the underlying breast tissue can push through, causing a mound under the areola. This can be corrected much like the problem of an excessively large areola; by reducing the areola's overall size and "tightening it up."

Many other variations of nipples and areolas exist which can cause embarrassment to patients, such as excessively long nipples or irregularly shaped areolas. Generally, a relatively minor procedure performed at the office is able to correct these concerns.

Dr. Chris Nichols is a board certified Plastic Surgeon and offers complimentary consultations. Contact our office today to schedule your appointment!

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Dr. Chris Nichols is a Board Certified Plastic Surgeon in Tacoma Washington specializing in all aspects of cosmetic and plastic surgery
including breast augmentation, liposuction, rhinoplasty and more.
6002 North Westgate Blvd. Suite 160, Tacoma, WA 98406