Nipples and areolas (the pigmented area around the nipple) come in a range of shapes, colours and sizes, and there may be a significant asymmetry between the two sides.
Sometimes they are not proportionate to the rest of the breast. To make them more proportionate as well as aesthetic, patients may need surgical areola reduction or reshaping. At times, it may even be necessary to reconstruct the whole nipple-areola complex from scratch when it has been removed due to breast cancer.
Surgical Techniques
There are various surgical and non-surgical techniques that are used to reduce or reshape the nipple and areola to make them more proportionate to the rest of the breast shape. Two of the most common complaints are an areola that is too large or a nipple that is inverted.
Inverted Nipples
Inverted nipples are usually a result of the ducts (milk channels) pulling the nipple in. This happens when the breast is developing but the ducts do not grow to the same extent. This can usually be corrected with a simple surgical procedure – there are small scars around the newly reshaped nipple and areola, but they heal well. Dr Safvat will discuss this with you and your plan for breastfeeding as it may be affected by the surgery. The surgery is done in an accredited Sydney hospital under a light anaesthetic and usually has very minimal downtime.
Enlarged Areola
Enlarged areolas can also be reduced. Dr Safvat uses a peri-areola incision (around the areola), which heals well with minimal scaring. This can be combined with breast reduction or breast lift to adjust the position or size of the breast as well. The recovery depends on the associated procedure (see section on breast lift or breast reduction) and will be discussed during your consultation in Ethique’s Concord, Miranda, or Bowral rooms.
Complications
While all care and diligence is taken by Dr Safvat to minimise or avoid complications, any surgical procedure can be associated with some general complications and/or specific complications related to the surgery you are having. Choosing a Specialist Plastic Surgeon such as Dr Safvat and having your procedure done in an accredited hospital minimises risks as does using an accredited Anaesthesist. Some general surgical potential complications are:
- Infection that may require antibiotics (Dr Safvat prescribes all patients antibiotics after surgery to minimise this risk).
- Fluid build up under the skin (seroma).
- Allergic reaction to dressings and other items used during the procedure.
- The formation of blood collection (haematoma) which could require additional surgery.
- Scars heal differently in different people. Some people are genetically prone to develop keloid scars. Hypertrophic scars develop when there is a complication in the healing process. Whilst not ideal, there is no threat to your health if you develop these.
- Although rare, heavy bleeding may occur at the operation site and even more rarely a blood transfusion may be required.
- Anyone can have a heart attack or stroke from a clot. This risk is slightly increased with anaesthetics.
Most patients undergoing this surgery will not experience complications, however it is important that all patients have enough information to weigh up the benefits and risks of surgery. The following are some possible complications of this particular surgery.
Areola Reshaping:
- Loss of nipple sensation and numbness may occur during the first few months. In most cases this is temporary, but occasionally numbness may be permanent.
- Nipples may become overly sensitive, again this is usually temporary
- Potential problems with breastfeeding, this is rare but as the areola is being cut there is the small chance that there can be damage to the milk ducts.
- Asymmetrical results
Nipple Correction:
- Swelling and sensitivity of the nipples is common initially but should subside over the first few months after surgery.
- In a very small number of the cases the correction may be partially successful and patients may need revision surgery.
- There is a chance that you might lose some nipple sensation. This may recover over the course of several months.
- To correct the inverted nipple the tethered ducts are cut. This will cause problems with breastfeeding. However, a patient will have difficulty breastfeeding with an inverted nipple anyway.
Dr Safvat will go through the specific risks associated with Areola and Nipple surgery with his patients, at their consultation in his Sydney and Bowral rooms.
Areola Reduction Surgery FAQs