Nipple Surgery

Nipple inversion – This 33 year old patient is seen 3 weeks after in office repair of inverted nipples. Inverted nipple repair can be a very straightforward procedure. It is best to delay this surgery until after attempting breast feeding as the scar tissue can interfere with milk expression. 

You might be a candidate for this surgery if you can easily pull out your nipple tissue. If it is difficult or you cannot externalize your nipples, surgery may not be successful.

In office release of inverted and cleft nipple. The right nipple is has more substance and therefore projection than the left.

This patient had severe nipple inversion. Implants help bring nipples out, but in this case, additional duct release was required. This procedure is not recommended for anyone who expects to breast feed in the future.

NIPPLE SURGERY INFORMATION

I love to perform nipple surgery.  Nipples can be made smaller, shorter, or sometimes longer depending on the desire of the patient.  One important point with nipple surgery is that the scar tissue can interfere with breastfeeding. Nipple surgery should only be considered after breastfeeding is no longer desired.


ONE OF MY NIPPLES APPEARS SUNKEN. WHAT CAUSES THIS?
Nipple retraction is a normal condition. It is caused by shortening of the breast ducts and fibrous connective tissue entering the nipple. If the condition occurred recently, it can be related to inflammation, injury, or in some cases, breast tumors. A careful exam and history are important parts of your evaluation.

WHAT CAN BE DONE FOR A RETRACTED NIPPLE?
The procedure for retracted nipples involves dividing the fibrous bands and supporting the nipple as it heals. Surgery for retracted nipples can be done in the office as an isolated procedure, or in combination with other surgery in the operating suite.  You can tell whether or not you are a candidate for this procedure if you are able to evert or make your nipple stand out with pressure. Some women have very small or flattened nipples and this condition is much more difficult to address.

WHAT CAN BE DONE FOR LARGE NIPPLES?
Nipple reduction surgery can easily be performed either in the office or in combination with other procedures in the operating room. Often women who are undergoing breast lift or breast reduction surgery will request reduction of the size of the areola, which is easy to combine with these surgeries.  Sometimes more than one reduction is requested to achieve the desired result.

MY NIPPLES SHOW TOO MUCH AFTER MY BREAST AUGMENTATION.  IS THERE ANYTHING THAT CAN BE DONE?
In patients with breast implants, nipples can be more visible in clothing, necessitating use of a padded bra, which otherwise might not be needed.  Trimming the length of the nipple is easily performed in the office under local anesthesia. For non-invasive solutions we recommend silicone nipple covers which can be found in lingerie departments or online.

BREAST FAT INJECTION INFORMATION
Fat injection to breasts is a very exciting procedure. Like all procedures, it needs to be approached with caution and a clear understanding of risks and benefits.  The ideal candidate for breast fat injection is someone who desires liposuction as a primary procedure or someone who could be a safe liposuction candidate. This “natural breast augmentation” is for someone who wants a small volume augmentation or reshaping of the breast.  Fat is sculpted into the breast and can expand certain parts of the breast or help get a more symmetric volume to the breast in a way that implants cannot accomplish. Approximately 60% of the fat injected stays in its new home, so there will be some change between your immediate post-operative results and your final volume.  The caution with fat grafting is that some of the injected fat will heal with scar tissue or oil cysts, which can be permanent. An expert radiologist can typically distinguish this from cancerous lesions of the breast, but these problems can be symptomatic requiring further surgery.


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