NIPPLE REDUCTION PROCEDURE
Patients often present for nipple reduction. This is a procedure where the patients present with nipple hypertrophy. Symptoms of nipple hypertrophy can include pain, excoriation, rash, embarrassment, psychological and self-esteem issues. It can also be difficult to wear clothing due to enlargement of the nipple with exposure. Excoriation, rashes and irritation of enlarged nipples also have been seen in our patients.
The operation is a procedure usually performed in combination with breast augmentation or breast lifting in which I perform a superior pedicle flap. Resection of the inferior half of the nipple is performed down to the base with a 15-blade. Subsequently, the superior pedicle is inferiorly rotated, fits down with simple 5-0 Prolene sutures. The 3 and 9 o’clock position of redundant skin is then trimmed carefully and those edges are sutured as well. Stitches usually remain in for approximately 14 days. Scarring is minimal to none in that the scars feel extraordinarily well. I have never experienced a hypertrophic keloid or widespread scar of the superior pedicle nipple reduction. The key to nipple reduction surgery is proportionality of the nipple to the areolar size.
Notice in the preoperative photographs this patient has an extremely large nipple in proportion to the areola. It is approximately 65% in diameter to that of the areola. Her postoperative view shows this has been reduced to approximately 45%. The vertical height and the base have also been reduced, allowing for more proportionality with the actual implant as well as the areola.