The nipple is the protuberant appendage of the breast. It is composed of all the milk ducts that converge to exit the breast. The areola is the darker coloured area that surrounds the nipple. Areolas vary in size, and they tend to be round or oval in shape. The entire area is called the NAC or Nipple Areola Complex.
Nipple reduction surgery reduces the projection (sticking out) of the nipple. It may reduce the circumference of the nipple depending on patient preference. Nipple reduction can be performed alone, or in conjunction with Breast Reduction Surgery, Breast Augmentation or Breast Lift.
Another condition commonly affecting the nipple, is Nipple Inversion. This is when the nipple sinks into the breast and is no longer protuberant. This is caused by a number of reasons –
- Hormonal changes with age – duct ectasia (floppy milk ducts)
- Benign conditions such as a breast cyst or benign breast tumour
- General Anaesthetic
- Day case
- 30 mins
- Stab incision at base of nipple to release the milk ducts
- Modified purse string suture at base of nipple
- Dressed with a “Sombrero Hat” dressing to prevent pressure on the area for at least 4 weeks.
Management will depend on treating the cause, and hence full breast work up with clinical examination, mammogram and breast ultrasound is initially required. If it is due to congenital reasons, and hence tight ducts, the procedure can be performed as a stand alone division of the ducts. Breast feeding is therefore not possible following Nipple Eversion.
Areolar correction surgery is often performed in conjunction with other surgery including breast lift, breast reduction and gynaecomastia reduction surgery. It may also be considered following massive loss of weight, post pregnancy and post breast feeding.
The procedure involves reduction in size of the areolar where a strip of areolar margin is superficially removed and then resutured so that the skin margin and the new areolar margin are placed back together with dissolvable sutures.