Nipple Reduction

Learn everything about your treatment

Some people may be unhappy with the size of their nipples as they feel they are too long or too puffy. They may be unhappy for a purely cosmetic reason, or it may be because their nipples are causing them discomfort. Some people also find that their nipples are asymmetrical as one is larger than the other.

  • Overview

    What are the nipples & areolas?

    The nipples are the raised, projected sections of skin that are usually found in the middle of the breasts. The areolas are the dark, round circles of skin that are found around the nipples, as shown below:

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    A nipple reduction is a surgical procedure that can tackle these concerns by reducing the size and the projection of your nipples, and restoring symmetry. The procedure itself can take anywhere between 30 to 60 minutes to perform, and can often be combined with a number of different breast procedures such as:

    • Areola reduction
    • Female breast reduction
    • Male breast reduction
    • Breast uplift
    • Breast reduction
    • Breast enlargement

    What is an areola reduction?

    Similarly, some people may also be unhappy with the size and symmetry of their areolas. An areola reduction is a surgical procedure that reduces the size of large or over-stretched areolas.

    It usually takes around 30 to 60 minutes to perform and can be combined with a nipple reduction, or the above-mentioned breast procedures.

  • Candidates

    Can anyone get a nipple or areola reduction?

    The best nipple and areola reduction candidates are men or women who wish to improve the size and symmetry of their nipples and areolas.

    The ideal candidate should also be in good health before the surgery, this means following a healthy diet, stopping smoking and maintaining a healthy weight.
    Finally, the best candidates for a nipple and areola reduction will have realistic expectations about what the procedure can achieve. During your consultation with your BAAPS/ BAPRAS surgeon, it is important to discuss whether your goals can be achieved.

    Nipple reduction candidates

    Male nipple reduction

    Many men may be unhappy with the appearance of their nipples and describe having puffy nipples. Excess breast tissue, enlarged breast glands or changes in weight may cause the nipples to push outwards. The appearance of puffy nipples may cause men to feel self-conscious about their nipples and affect how comfortable they feel in certain items of clothing or when doing activities that require a bare chest, such as swimming.

    Female nipple reduction

    Many women experience problems with their nipples such as having nipples that are an irregular shape or size. These irregularities may cause distress, discomfort or chafing when wearing certain clothing. Nipple size and shape can be affected by things such as weight loss or gain, and changes to the breast after pregnancy or breastfeeding.

    Areola reduction candidates

    Male areola reduction

    Some men may feel self-conscious about the size or symmetry of their areolas and they may wish to have an areola reduction procedure to reduce the size or correct any asymmetry. When you attend your consultation, your surgeon will be able to inform you

    Female areola reduction

    Many women are unhappy with the size of their areolas and may have experienced stretching of their areolas after losing a large amount of weight or following pregnancy and breastfeeding.

    What will a nipple reduction not resolve?

    A nipple reduction procedure will solely address problems with the size and shape of the nipple itself. This is the raised, central part of the breast. A nipple reduction will not change the appearance of the areola, which is the darker circular areas around the nipple. If you have concerns regarding the size or shape of your areola, you may wish to have an areola reduction procedure.

    Depending on your concerns, you may wish to have an areola reduction instead of, or in combination with, a nipple reduction procedure. If necessary, the two procedures can be performed at the same time. You should discuss with your surgeon exactly what you wish to change in the appearance of your breasts so that they can advise you as to what procedure is right for you.

  • Procedure

    How is a nipple reduction procedure performed?

    The technique that your surgeon will use to reduce large or puffy nipples will depend on whether you are only having a nipple reduction procedure, or if you are having the procedure in combination with another procedure such as an areola reduction or another type of breast surgery.

    Below will give you an overview of what the nipple reduction procedure will involve, from start to finish.

    1. Consent

    Before you undergo your nipple reduction surgery, you need to give your consent for the procedure. You will do this by signing a consent form on the day of or before your surgery. Make sure you have had enough time to fully discuss with your surgeon how the procedure will be performed, and its benefits, risks, and complications. If you have any uncertainties about the surgery, ensure you have clarified these with your surgeon before you sign the consent form. Once you are happy to go ahead with the procedure, your surgeon may draw incision lines with a surgical marker on the treatment area to demonstrate where he or she will be making the surgical incisions.

    2. Anaesthesia

    Next, you will meet your anaesthetic in the anaesthetic room. The anaesthetist is the doctor who will be administering the anaesthetic drug. For a simple procedure such as a nipple reduction, you will usually have a local anaesthetic. This will numb the treatment area so you do not feel anything during the procedure. Your anaesthetist may also give you a sedative drug at the same time, to help you feel relaxed. Sometimes general anaesthetic will be used if this was discussed prior to your operation.  This will put you to sleep throughout the entire operation, but bear in mind this type of anaesthetic generally carries more risks.

    3. Incisions

    You will move to the operating theatre where your surgeon will prepare you for the operation. He or she will begin by cleaning the treatment area and draping over a sterile sheet. Your surgeon will then make an incision; for a nipple reduction procedure, this is usually a circumareolar incision.

    The circumareolar incision goes around the full circumference of the base of the nipple. The surgeon then cuts away the extra tissue and pulls the rest of the nipple in towards the breast. The result is a reduction in nipple length.

    4. Closing of incisions

    Your surgeon will use stitches to secure the nipple into its new position and close the incision. The surgeon may use absorbable and/or non-absorbable sutures. They will then apply a light dressing to help protect the treated area.

    5. Return to the ward

    Once the surgeon has completed the procedure, you will move to a recovery room. Over the next few hours, the anaesthetic will gradually wear off. The nurses on the ward will ensure you are comfortable and at ease.

    What incisions are made for an areola reduction procedure?

    Similar to a nipple reduction procedure, the technique that your surgeon will use to reduce the size or puffiness of the areolas will depend on whether you are only having an areolar reduction procedure or if you are having the procedure in combination with another procedure such as a nipple reduction or another type of breast surgery.

    For an areola reduction procedure, the following two circumareolar incisions are made:

    Around the base of the nipple.

    Towards the outer part of the areola

    After your surgeon makes these two incisions, the excess part of the areola is removed and the remaining skin is pulled together with stitches.

    If the areola is particularly large, an extra incision may be made from the base of the nipple down to the outer edge of the areola. This is called a large areola reduction procedure and it allows the surgeon to remove more excess skin.

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  • Your consultation

    What should I expect from my nipple reduction consultation?

    If you are considering a nipple or areola reduction and think this is the right procedure for you, the first step is to have an initial consultation. This is the time for you to meet with one of our BAAPS/BAPRAS surgeons to talk through what the operation involves. This will take approximately 15 minutes to an hour.

    During your nipple reduction consultation, you should discuss with the surgeon what you want to change about your nipples or breasts. You should be as clear and open as possible about your concerns and expectations so that the surgeon understands exactly what it is you want to achieve. The surgeon will consider your goals and may examine your nipples. They will then be able to tell you whether this procedure will get you the results you are after. Alternatively, they may suggest a different procedure such as an areolar reduction, if they feel this is more appropriate.

    Your surgeon will also talk you through the risks and complications of the surgery. They will need to ask you some questions to assess if you are suitable for surgery. For example, they may ask:

    • Do you suffer from any other medical conditions?
    • Have you had any medical conditions in the past?
    • Have you had any surgeries in the past?
    • Do you currently take any medications, including over-the-counter and herbal remedies?
    • How many units of alcohol do you drink in a week?
    • Are you a smoker?
    • Are you allergic to any medication?

    It is important that you answer these questions honestly and give your surgeon as much information as possible.

    What questions should I ask during my nipple reduction consultation?

    Your nipple (and/or areola) reduction consultation will also be an opportunity for you to ask the surgeon about anything you are uncertain of. You might find it helpful to write down some questions before your consultation to bring with you. Some things you might want to ask may include:

    • Is a nipple reduction appropriate for what I wish to change?
    • Do you have any before and after pictures of previous nipple reduction surgeries?
    • Where will the scars be, and how small/big will they look?
    • How long is the recovery period?
    • How much time do I need to take off work after the surgery?
    • Will my nipples be sore after surgery?
    • How soon until I can see the final results?

    The surgeon will answer your questions to the best of their ability. Most surgeons strongly recommend a two week “cooling off period” between your consultation and having a procedure. This is to ensure that you have had time to think everything through and know that this is the right choice for you at this time.

  • Risk & Complications

    What are the main nipple reduction risks and complications?

    General surgical complications

    Some general risks and complications that can occur in any surgical procedure include:

    • post-operative nausea and vomiting.
    • the development of a blood clot in your leg or lungs.
    • an allergic reaction to the anaesthetic.
    • post-operative pain.

    Bruising and bleeding

    Most people will experience some bruising or bleeding after surgery. Bruising around the treatment area is common and can take up to two weeks to fade completely. It is also normal to see some minor bleeding in the dressing right after the surgery. If, however, your wound bleeds more than normal, you may be required to stay in the hospital until this settles. You should let your surgeon know if you notice any blood oozing from your wounds.

    Infection

    If bacteria enters your wound during or after surgery, an infection may develop. The signs of infection you should be aware of are the following:

    • Temperature over 38° C.
    • Redness at the incision line that is spreading away from the incision after 48 hours.
    • Yellow pus-like or foul-smelling fluid seeping from the incision.
    • Increased pain or discomfort of the treated area that pain medication does not resolve.

    Let your surgeon know immediately if you notice any of these signs so that the infection can be treated promptly. Mild infections can be treated with antibiotics. Rarely, if the infection has spread further, you may require a further operation.

    Scarring

    Scarring is to be expected with any surgical procedure. However, a nipple reduction is a minor procedure so scarring should be minimal. You can discuss with your surgeon the size and location of the scar you can expect. Scarring will fade over time. Follow your surgeon’s specific advice on how to take care of your wounds. This can help aid the healing process and minimise the scarring.

    Numbness or loss of sensation

    It is possible that you may notice a change in the sensation of your nipples. This can include numbness, tingling, or pain in or around your nipple. Usually, this change in sensation is only temporary and will eventually settle. However, on rare occasions, it is possible for the permanent loss of nipple sensation to occur.

    Inability to breastfeed

    A nipple reduction procedure may affect your ability to breastfeed. Talk to your surgeon if you have plans to breastfeed in the future. Your surgeon may advise you to wait until after you have completed your family to undergo a nipple reduction if you have a desire to breastfeed.

    Aesthetic

    There is always a possibility that you are unhappy with the results of your surgery. This may be due to asymmetry or scarring. This is not always caused by a surgeon’s lack of skill or expertise. Some irregularities in scarring or discolouration may occur according to your body’s ability to heal. Furthermore, if you become pregnant or your weight changes dramatically, this can change the shape of your nipple. You can minimise the chances of being unhappy with your results by clearly discussing your aesthetic goals with your surgeon.

  • Preparing for your treatment

    How can I prepare for a nipple and areola reduction?

    Although a nipple (and/or areola) reduction is a relatively simple and short procedure, it is still important to be prepared for the surgery. Remember, even small changes in your lifestyle can make a dramatic difference in the way you heal and recover from an operation. Make sure that in the weeks before your surgery you stop smoking, maintain a healthy diet and get some exercise when possible. To ensure that you feel ready for your surgery, we have listed some further nipple and areola reduction preparation tips below. Following these tips in the run-up to your operation will help ensure a smooth procedure and the best results.

    What can I sort around the house before surgery?

    Household work

    To make your life easier for when you return home after surgery, it’s a good idea to either complete some household tasks beforehand or allocate these to another household member. For example, you may wish to give the house a clean. It is also a good idea to take the rubbish out so that you can avoid having to lift heavy, full bin bags right after your operation.

    Shopping

    We recommend that you do a big food shop a day or two before your operation and stock up on groceries that you will need for the week after your surgery. This will mean that you do not need to make a trip to the supermarket in the early days after your surgery, when you may not feel up to leaving the house.

    What else should I consider ahead of time?

    Young children and pets

    If you have children or pets, you may wish to ask a friend, relative or babysitter to look after them for you during your recovery period. After surgery, you may lack your usual energy so doing this will take some pressure off you. This will also allow you to fully relax so that you can rest and recover properly.

    Driving

    The effects of a general anaesthetic may leave you feeling tired and groggy in the hours after the surgery.  Therefore for your own safety, you will not be allowed to drive for 24 hours. Arrange for a friend or family member to meet you at the hospital after the surgery so that they can drive you home. Depending on how you feel, you may wish to have them stay with you for at least the first night. This is especially important if there is no one else at home. Having a familiar face with you after an operation will make you feel more at ease.

    Diet

    A healthy diet is a very important part of preparing for any type of surgery. Eating a balanced diet in the weeks before will allow your body to be in a better state for a surgical procedure. Eat lots of nutritious fruit and vegetables, as well as foods high in protein such as chicken, fish or tofu. Keep your intake of caffeine and sugary or salty foods to a minimum, and stay hydrated by drinking plenty of water.

    What are some post-operative tips?

    Clothing

    After your nipple reduction procedure, it is best to wear loose items of clothing. This is so that the clothing does not rub against the treatment area, which may at first feel slightly sore. Therefore, before the day of your surgery, make sure that you have enough appropriate clothing ready for your recovery period. We recommend light, loose t-shirts and comfortable lounge pants to rest in.

    Sleeping

    In the week leading up to your surgery, try and make time to get enough sleep every night. Sufficient rest is crucial for allowing your body to prepare for a surgical procedure. Also, make sure that you have enough pillows prepared for after the surgery. Resting on these in an elevated position can help to reduce any swelling you may experience around the treated area.

    Whilst these nipple and areola reduction preparation tips should help you feel more ready for surgery, you should always follow your surgeon’s specific preparation instructions.

  • Aftercare

    What can I expect after a nipple and areola reduction?

    It is important to be aware of what you should expect after a nipple and areola reduction procedure so that you can go into the surgery feeling prepared. There are certain aspects of nipple reduction aftercare that you will need to follow in order to ensure that the treatment area heals well.  This includes taking time off work,  avoiding strenuous exercise, and washing and caring for your wounds properly. Below we have covered some of the basics of nipple reduction aftercare, however, your surgeon will give you specific advice and further information that you should follow.

    How will I feel after surgery?

    After the surgery, your wounds will be covered with dressings. These will stay in place for a couple of days before being removed. The treatment area may at first feel slightly tender and sore. You might also notice some minor swelling or bruising around the area. Your surgeon may suggest that you take painkillers to ease any discomfort and reduce any swelling. As a nipple reduction is a minor procedure, you will usually be able to return home on the same day.  However, if you were put to sleep with a general anaesthetic, you may be required to stay a night in the hospital. You may also feel tired and groggy from this anaesthetic.

    Is there anything I need to do in the first 24 hours?

    It is a good idea to have another adult stay with you for at least 24 hours after the surgery. Particularly if you have had a general anaesthetic, you may feel tired or dizzy so it is best to have someone around. Having a friend or relative stay with you whilst you recover will also mean that they can help you with certain tasks like cooking or cleaning until you are back to your usual self.

    How much time do I need to take off work?

    The length of time you should take off work after your surgery will depend on your job. If your work is active and requires you to be on your feet, we advise that you take at least one week off. However, if you have an office job it may only be necessary to take a few days off. Your surgeon will give you a specific time frame that you should follow.

    When can I return to exercise and sport?

    Immediately after the surgery, it is important that you fully rest to allow your body to heal. Strenuous physical activity, particularly in the first week, can increase swelling and affect your recovery. You can gradually start resuming physical activities after a couple of weeks. Start off with some light walking, then gradually resume sports that do not require vigorous movements, like cycling. After 4 to 6 weeks, you should be fine to get back to your usual fitness regime.

    What other points should I consider?

    Swelling & Bruising

    Some swelling around the nipple may occur after your nipple reduction surgery. You may also notice some mild bruising around the area. This is common and should generally begin to settle after 3 to 4 days. For the first few weeks avoid activities that may increase swelling, such as vigorous exercise, lifting heavy objects, or using saunas and hot-tubs. Try not to touch the treated area too much, and sleep on your back rather than your front to avoid compressing the nipples.

    Scarring

    You will have minimal scarring following a nipple reduction surgery. For the first few weeks, any scars may appear pink and raised. Over time they will fade to faint white lines which will be discreet and barely noticeable. Taking care of your scars by moisturising and protecting them from sun exposure can help with the healing process.

    Clothing

    You should avoid wearing items of clothing that compress the nipple for at least 2 weeks. This includes tight, fitted clothing and padded bras that can cause friction with the treated area. It is, therefore, best that you wear loose, comfortable clothing during your recovery period.

    When will I see the final results?

    You will most likely see a noticeable difference in your nipples immediately after the surgery. However, it is important to be patient as it can take up to 6 weeks to appreciate the full cosmetic results. This allows time for any swelling and bruising to settle and for your scars to fade. After the operation, your surgeon will cover the treated area with a protective bandage or dressing to support the nipple in its new position. Your surgeon will tell you how long this needs to be kept on for. Listening and adhering to your surgeon’s post-operative advice is essential in order for you to achieve the best results from your surgery. A follow-up appointment within a couple of weeks will be organised for you as part of your nipple reduction aftercare. Your surgeon will check your wounds to ensure they are healing well and will remove any stitches if necessary.

  • FAQs

    What are some common nipple and areola reduction FAQs?

    It is important that you ask your surgeon any and all questions you have before your nipple and areola reduction procedure. Common nipple and areola reduction FAQs include the following:

    Can I have this procedure if I have pierced nipples?

    As long as your piercings are not new and have fully healed, your pierced nipples should not prevent you from having a nipple reduction procedure. However, your surgeon will have to examine your nipples during your consultation and only they can tell you if the procedure is possible. It is important to note that you will have to take the piercing out before the surgery.

    Will I be able to breastfeed after a nipple and areola reduction?

    It may be possible to breastfeed after a nipple and areola reduction. However, this depends on a number of factors including what surgical technique the surgeon uses. Therefore, it is usually advised that you postpone this surgery if you have plans to breastfeed in the future. It is best to discuss with your surgeon about how this procedure might affect your ability to breastfeed, and what the most appropriate option is for you.

    If you have recently had a baby and are currently breastfeeding, your surgeon may require you to wait for 3 to 6 months before you have a nipple reduction. This is so that your breasts and nipples can settle before the procedure.

    Are there any non-surgical options for nipple reduction?

    Currently, there are no options other than surgery that can reduce the size of the nipple. Your surgeon can discuss with you the best surgical technique and procedure for you that will achieve the results you desire.

    How long will it take until I see the final results?

    While you may notice an immediate difference in the appearance of your nipples, your final results will take time. It can take up to 6 weeks to appreciate the full cosmetic results. By this time, any swelling and bruising will have settled, and scarring should start to fade.

    What are the effects of smoking, drugs, and alcohol on nipple surgery?

    Smoking and drinking increase the risks and complications of surgery. It can also make your recovery period longer as smoking can affect the healing process of the skin and tissue. We therefore strongly advise that you stop smoking at least 6 weeks before your surgery. It is also important to restrict your alcohol intake. Furthermore, let your surgeon know if you regularly take any medications or supplements. It is possible that they may have an effect during the surgery. Your surgeon may advise you to stop taking these prior to surgery if this is the case.