Nipple Surgery – Nipples during Breast Surgery
How does a Plastic Surgeon go about changing the shape or size of nipples during breast surgery? Find out more in our brief breast surgery with nipple reshaping blog.
The Anatomy of the Nipple
Firstly, we’ll describe the anatomy of the breast area known as the nipple. This area is the nipple areola complex. It is the broader area of the nipple rather than the most elevated tip.
- Nipples are usually circular in nature, but can vary significantly
- They can be oblong, different in size or colour or shape
- Nipples are typically more pigmented (darker) than surrounding tissues
- The colour of a breast nipple can range across many different skin tones or shades; e.g. pale beige, pink, tan, orange or dark brown
- Nipples themselves have small openings circling the tip of the uppermost part of the nipple area (these are known as lactiferous ducts)
- The average number of lactiferous ducts a woman has around each nipple is typically between 15 and 25
- An inwardly facing nipple (one that appears indented versus outward protruding) is known as an inverted nipple
- Inverted nipples can typically be corrected with plastic surgery, including when having a breast reduction surgery or a breast lift procedure
- The glands of montgomery appear as tiny bumps in the larger area around the protruding (or inverted) nipple, e.g., sebaceous glands or Montgomery’s glands are located on the nipple aerola complex or “NAC”
- There average number of montgomery glands on the nipple is 9
- Montgomery glands may become enlarged during pregnancy
See the illustration below this list of anatomical descriptions of the nipple aerola complex region of the chest.
- Asymmetry is common but extreme asymmetry can cause discomfort or self-consciousness in some women
- The left and right nipples are rarely perfectly even or symmetrical in size, colour or shape; most asymmetry, however, is minimal and not a concern to women; but when the asymmetry is more noticeable or severe, corrective breast surgery with nipple reshaping surgery may be sought
- Extreme asymmetry can involve the:
- location of the breast tissues or nipple
- size and shape of the breasts including the nipple area
- and/or may involve only the appearance of the nipple area but not the overall breasts
- Nipples can change after pregnancy and breast feeding, including becoming larger, misshapen or stretched
- Nipple hair is not uncommon
Can you change your Nipple Size or Nipple Shape during Breast Surgery?
Changing nipple size, shape or location is an option for women having procedures including breast lift, reduction, or corrective surgery for asymmetry. Some women simply want a smaller or more rounded shape to the entire nipple aerola complex. Further many want to position the nipple more centrally on the breast mound to reduce the appearance of sagging breasts. Read the scientific study of breast nipple location aesthetics. Others want to even up the nipples to appear more similar. Some women with very long nipples (protruding nipples) may choose to reduce the dimensions of the protruding nipple itself with, or without, a reduction in the size of the areola area.
An example of changing the nipple size and shape during a breast surgery procedure is shown below. The procedure performed was a breast reduction with a breast lift.
Nipple Problems That May Require Nipple Surgery
- Mammary-duct-ectasia (when a breast milk duct becomes clogged or inflamed, and may involve discharge)
- Born without nipples and want to create the appearance of nipples through surgery or tattooing. This condition, known as athelia, is rare
- Other complications of breast glands or breast functions
- Breast cancer
- Ptotic nipples (ptotic breasts) that sag
- Pendulous breasts or heavy, large breast volumes that lead to shoulder pain, neck pain, back pain and difficulty finding good support bras
Breast reduction and breast lift surgery are some of the most common breast surgeries performed that can also allow your plastic surgeon to reshape and resize the nipple area through surgery, to give the appearance of more even or more circular nipples.
Example of a breast reduction surgery results where the nipple was made smaller and more roundedAll rights reserved. If you want to see more breast reduction or breast lift results, visit our Gallery of Before and After Breast Lift Surgery images and the Before and After Breast Reduction Photos.
Why Reshape or Resize Nipples During Breast Surgery?
Breast surgery is also a good opportunity to resize or reshape your nipple complex to be smaller, more rounded or more even and symmetrical in size and location. For primary breast augmentation procedures that do not require an uplift (breast lift), the nipples themselves are not directly changed. However, due to the size and shape differences of more volume in the breast area, the nipples may look differently than they did before surgery. This is due to the added volume to the breast area from inserting implants.
Surgeons can reduce ptosis through the use of both round or anatomical implants. However the success of a breast augmentation without a lift depends on the health, collagen levels and condition of the skin (breast envelope). Often, women may need a breast lift as well as an augmentation to raise the nipple to the desired location. This reduces the appearance of sagging breasts and aesthetically improves the appearance of the chest area.
Breast implants, inserted strategically under the muscle, can sometimes slightly elevate or alter the projection of the nipple in relation to the overall breast mound. But sometimes breast implants alone will not sufficiently reduce downward sagging nipples (breast ptosis) and sagging skin. In fact, breast implants may worsen sagging breast tissues over time.
Other Surgical Solutions for Nipple Correction
No two breasts or nipples are perfectly alike. This leads to the common expression that ‘breasts are more like sisters than twins’.
However, if you have uneven breasts that appear very different in size, shape or location on the chest, this is known as breast asymmetry or nipple asymmetry. Uneven breasts or heavy, pendulous breasts may lead some women to seek corrective breast surgery such as:
- Breast lift with nipple reshaping
- Reduction mammoplasty (breast reduction including liposuction for enhanced shaping)
- Breast lift combined with augmentation using breast implants to create fuller breasts when the breasts appear empty or deflated after breastfeeding or menopause
Male and Female Breast and Nipple Differences
Male and female breasts are not dissimilar but women tend to have larger aerola complex areas than men. Prolactin levels, a hormone that can lead to milk production abilities of the breasts/milk duct glands – and which becomes especially elevated during pregnancy – is much higher in women than men (generally); unless a hormonal condition or medication side effect has impacted the normal levels of hormones that impact breast tissues.
Further, estrogen is higher in women and this contributed to women’s breast development including breast size and milk production/lactation functions, whereas men’s breasts do not tend to develop in this manner. Sensitivity of the breast and nipple area is common in males or females; this can, however, vary from person to person.
Nipple Surgery with Dr Craig Rubinstein
Dr Rubinstein specialises in breast reduction surgery and other breast surgeries including breast augmentation, breast lift and asymmetry corrections. He is also dedicated to minimising your breast surgery scars, including using drain-free processes for most patients and the Le Jour method incision strategies to help reduce your surgery scars along the breast crease.
His practice is focuses on women’s surgery only (breast surgery and abdominoplasty); he is one of Melbourne’s most highly respected breast and tummy tuck/abdominoplasty surgeons.
Please Contact Dr.Rubinstein’s office to book a consultation or enquire about further information regarding plastic surgery procedures.