Procedure Spotlight

  • Areolas can have asymmetry or they may not be proportionate to the rest of the breast
  • Inverted nipples can affect both men and women
  • Both Inverted Nipple correction and Areola reduction are minor surgeries with minimal downtime
  • Areola reduction and most inverted nipple correction procedures are considered full cosmetic procedures

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. In some cases, they are not proportionate to the rest of the breast. 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.

Inverted nipples can affect both men and women. Inverted nipples are where the nipples point inwards instead of outwards. Inverted nipple correction, is a surgical procedure aimed at increasing the projection of the nipples to improve the appearance of the breasts.

Dr Safvat will review you during consultation and discuss your options based on which level of Nipple inversion you have:

Level 1 – The nipple is inverted but will project normally when responding to cold or touch. The projection is usually only temporary.

Level 2 – The nipple is always inverted but using suction may bring it out for a short time.

Level 3 – The nipple does not project even with stimulation (cold or touch) or suction. This stage is when surgery is most common as the tissue beneath the skin is constricted.

Dr Safvat will help you determine the best treatment option for you and your individual situation.

Technique

Enlarged Areola

Enlarged areolas can be reduced. Dr Safvat uses a peri-areola incision (around the areola), which heals well with minimal scaring. This can be done as an independent procedure or more often it is combined with breast reduction or breast lift to adjust the position or size of the breast as well if needed. 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 Miranda, Bowral or Concord rooms.

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.

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 and to correct inverted nipples.

Procedure Snapshot

Anaesthetic Type: Light General Anaesthetic
Length of Surgery: 1 hour
Stay in Hospital: Day Only
Downtime: Minimal – 1-2 days at the most

Recovery

Areola Reduction

While some bruising and swelling will be present, patients don’t usually need to take more than two days off work. Any discomfort can easily be managed using pain medication. A soft surgical or sports bra will need to be worn for several weeks and any physical movements that could affect the chest, nipples, and areolas should be avoided for at least 3 weeks. The ring-shaped scar around each areola can take up to 12 months to mature.

Inverted Nipple Correction

After your procedure, a dressing will be applied to the nipple. Physical activity should be avoided for several weeks, particularly activities that could affect your chest, nipple, and areola. Bruising, swelling and discomfort can be expected after surgery but this won’t last long. Pain medication can help with any pain. Patients can return to work again within a day or two. For 6 weeks, it’s also important not to apply any pressure to the nipple.

Both surgeries are done in an accredited hospital under a light anaesthetic and usually have very minimal downtime.

Preparation

Smoking and being overweight have been shown to cause significant complications after areola or nipple surgery. Dr Safvat will insist that you stop smoking a minimum of 3 weeks before your surgery and lose as much excess weight as possible. Ideally you should be in the normal BMI range before your surgery.

Scars

There is no way to prevent scars completely after surgery and everyone can scar differently. However, the techniques Dr Safvat uses to suture his wounds are designed to minimise scarring. What’s more, any scarring will fade over time, especially if they are cared for correctly.

The scar for areola reduction goes around the areola and heals well. The scars for inverted nipple surgery are very small and will be hard to see once fully matured.

Patients who have followed Dr Safvat’s protocol for scar management diligently have been very pleased with their progress in reducing and fading of scars. Dr Safvat will also include LED Light Therapy sessions (available in Miranda only) which will assist with wound healing, scarring and recovery.

Dr Safvat will provide you with his specific protocol for scar management that will help you protect and care for your incision in a way that will minimise scarring.

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 Anaesthetist.

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.

  Anyone can have a heart attack or stroke from a clot. This risk is slightly increased with anaesthetics.

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.

  Scar may widen depending especially if significant reduction in the size of the areolas is done.

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. But it is recommended that if you are planning to have children and breast feed to postpone the correction of your inverted nipple surgery until after you finish breast feeding.

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.

Cost

Inverted nipple correction surgery

Inverted nipple correction surgery a Medicare item number in some cases only meaning those  patients that qualify should get a rebate from Medicare and their health fund (where applicable). The hospital costs are usually covered by private health funds depending on the patient’s level and type of coverage. Alternatively, you can have the procedure done in a Private Hospital as a Self-Funded patient. If the surgery is classified as cosmetic, no rebates will be available and there will be private hospital fees involved.

Areola reduction surgery

This is considered a fully cosmetic procedure and therefore there will be no rebates available and you will required to pay for all of the costs.

Detailed information regarding costs will be provided to you after your initial consultation.

Areola Reduction Surgery FAQs

WHAT CAN I EXPECT DURING THE PROCEDURE?

Areola reduction surgery doesn’t usually take longer than two hours to complete but will require a light general anaesthetic. During the procedure, Dr Safvat will remove a round piece of tissue from the areola. Since the incision is made along the border of the areola, scarring is less visible. Dissolvable stitches will be used to close the areola incision.

ARE THERE ANY RISKS AND COMPLICATIONS I SHOULD KNOW ABOUT?

Along with the complications associated with surgery in general, areola reduction can, in some cases, cause a loss of nipple sensation, scarring and problems with breastfeeding. Every possible measure is taken to keep risks and complications to a minimum. At Ethique Plastic Surgery, Dr Safvat will take you through his methods for doing so during your consultation.

CAN I BREASTFEED AFTER AN AREOLA REDUCTION?

When a piece of the areola is removed, there is a chance that the milk ducts can be damaged. However, Dr Safvat takes every measure possible to prevent this from happening. Following areola reduction surgery, there is a small chance that you will be unable to breastfeed again in the future.

Where does Dr Safvat perform this procedure?

Dr Safvat does Nipple/Areola procedures in the Sydney region (Sutherland Shire and Inner West) as well as in the Southern Highlands, NSW. He only operates in fully accredited Private Hospitals, these being Kareena Private Hospital (Caringbah), Strathfield Private Hospital, Southern Highlands Private Hospital (Bowral) and Ramsay Surgical Centre Miranda.

Nipple Correction Surgery FAQs

WHAT CAN I EXPECT DURING NIPPLE RESHAPING SURGERY?

There are several different techniques that can be used to correct an inverted nipple. One of the most popular involves making an incision at the base of the nipple. This will help release any tension caused by the milk ducts. Once an anaesthetic is applied, the procedure usually won’t take longer than an hour to complete. Since this is a day procedure, no overnight stay is necessary.

WHAT ARE THE RISKS AND COMPLICATIONS INVOLVED WITH THIS PROCEDURE?

Along with general surgical complications such as infection, re-inversion of the reshaped nipple is possible in a small number of cases. Unfortunately, this will require a second surgery to correct. There is also a chance that you might lose some nipple sensation. However, in most instances, any numbness does subside over the course of several months.

CAN I BREASTFEED AFTER NIPPLE RESHAPING SURGERY?

If you have an inverted nipple/s, you will probably struggle to breastfeed. Dr Safvat will discuss your options during consultation. Releasing the ducts that tether the nipple will make it unlikely that you will be able to breast feed after the surgery.

IS NIPPLE CORRECTION SURGERY RIGHT FOR ME?

Inverted nipple correction is a procedure that may not be suitable for everyone. Dr Safvat will assess you during consultation and discuss your options for surgery and whether it is suitable for you.

Inverted nipple correction surgery may be appropriate for you if:

  • You are healthy and have a stable weight
  • Your breasts are fully developed
  • Your nipples are always inverted
  • You are unable to breast feed because of nipple inversion or not planning to have anymore children
  • You have realistic expectations about the outcome of the surgery
Where does Dr Safvat perform this procedure?

Dr Safvat does Nipple/Areola procedures in the Sydney region (Sutherland Shire and Inner West) as well as in the Southern Highlands, NSW. He only operates in fully accredited Private Hospitals, these being Kareena Private Hospital (Caringbah), Strathfield Private Hospital, Southern Highlands Private Hospital (Bowral) and Ramsay Surgical Centre Miranda.

Before and Afters

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 Dr Safvat is a fully qualified Specialist Plastic Surgeon. Every patient is unique and results may vary. Any surgical procedure carries risks which need to be discussed with your doctor to ensure you are fully informed and realistic outcomes have been explained. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

These photos are of actual patients of Dr Safvat. Each has given consent for the photos to be used by Dr Safvat only.

 

DR ANDRE SAFVAT (MED1155201)
Registered Medical Practitioner, Specialist Plastic Surgeon (specialist registration in Surgery – Plastic surgery).

Dr André Safvat – Specialist Plastic Surgeon

Renowned for his dedication to his patients, his attention to detail and impeccable outcomes, Dr Safvat’s unparalleled expertise is reflected in the quality, professionalism and dedication of every member of our team.