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Slight differences in the size and shape of nipples and/or areolas (the small circular area surrounding the nipple) are very common for most individuals. But in cases where the difference in size is very noticeable, a balance can be achieved to make nipples more even and symmetrical via nipple revision surgery. Breast augmentation (enlargement), breast reduction, or breast lifts (mastoplexy) are sometimes performed in conjunction with a nipple revision.
If patients are unhappy with how large their nipples and/or areolas are overall, these prominent parts of the breast can also be reduced with a nipple revision to make them smaller.
As double board-certified plastic surgeons with years of experience in breast surgeries, Drs. Steven Svehlak and Daniel Yamini use multiple techniques to reduce the diameter and length of the nipples. In very broad terms, during a nipple revision (reduction), a part of the nipple’s skin may be removed, leaving the milk ducts, nerves, and other functional parts intact.
Nipple revision is a form of plastic surgery that is used to:
In many instances, if no other breast procedures are being done, the nipple and/or areola procedures can be done under a local anesthesia in the office treatment room. The person is awake but can be given a mild relaxing medication such as Xanax.
After a nipple revision surgery, the nipples and/or areolas that have been operated on may feel tender, numb, and/or puffy. This is due to localized swelling, and should resolve on its own over time. Different degrees of swelling may temporarily cause the appearance of asymmetry in the nipple or areola areas.
Heat may cause further injury to the operated areas, and should never be used to soothe the skin. Instead, cool compresses may be recommended, depending on what your doctor decides is most appropriate for your unique recovery pattern.
The period for recovery from a nipple revision can vary depending on whether a breast augmentation, reduction, or lift was also performed during the operation.
You may need to wear special tape and/or a post-surgical bra to minimize swelling and support the breasts. Expect to feel tired, and for your breasts to feel tender or numb for at least the first 24 to 48 hours. Your doctor may ask you to continue wearing the surgical support bras at all times for several weeks. Once the wounds have started to heal, a gentle, unscented moisturizer may be used to combat dryness and flakiness of the skin in the nipple-areola area.
Most patients take one to two weeks off from work and normal activity after surgery, and strenuous activity may not be allowed for six weeks after the operation. Avoid lifting and pushing for two weeks–no heavy lifting or pushing for four weeks.