Proportion is the essential ingredient of all things beautiful in the human experience. And so it is with the breast. An excessively large areola can create an undesirable visual distraction if by virtue of its’ size, it dominates the breast. In my opinion, the diameter of the areola should ideally be no more than 1/3 the visual diameter of the breast, and in general less than 5cm. The areola of the breast may naturally be or become excessively large for a variety of genetic or experiential reasons. Sometimes, due to developmental differences, one breast may look tuberous (shaped like an onion or beet) and have a large areola. Other causes of large diameter areolas include excessively large breasts or saggy breasts which grew with pregnancy and have residual large areolas. Regardless of the cause, we now have reliable procedures to reduce the areola diameter and keep it from enlarging again after surgery. Areolar reduction surgery will either leave a scar around the areola, or around and vertically downward toward the breast fold. Scar appearance will improve over a 2 year period to the point of (usually) looking imperceptible.
Inverted Nipple Repair
Inverted nipples are a common problem which fortunately is a treatable condition. Less than 10% of the female population suffers with inverted nipples, which represents an alteration in normal nipple development. Instead of protruding like a normal nipple would with stimulation, the inverted nipple remains “sucked in,” with a slit like appearance to the nipple. This minor yet embarrassing condition has received very little focus or patient support from the medical community. I am happy to advise you that there is a very reliable procedure available to correct this condition. It can be performed under local anesthesia; however the vast majority of women have it corrected under general anesthesia. The nipple is retracted up and out of its “sink hole” and the shortened incompletely formed nipple ducts are released and the nipple bud allowed to sit on top of the areola. Sutures are used to prevent relapse.
Large Nipple Reduction
A nipple will look large if it dominates or excessively over projects the surrounding areola. A nipple can look large because it is big in all dimensions, like a small marble, or because it is long and projecting like a cigarette butt. In yet another instance, the nipple may look large because the areola diameter is small. In either case, large nipples are most often present on breasts which otherwise appear to be perfectly normal, and on women who are usually of average height and weight. Large nipples usually do not have any functional limitations (such as interference with breast feeding), but the size of the nipple can create undesirable visibility of the nipple through clothing. There are several different surgical remedies used by a Plastic Surgeon in Las Vegas to reduce large nipples.
The procedure I use I call an “apple core nipple reduction” because removing skin from the sides of the nipple makes the nipple temporarily look like an apple core. In addition to “unwrapping “ the sides of the nipple and collapsing it , we can also take a wedge or section out of the tip of the nipple to make the nipple diameter smaller. I perform this large nipple reduction, procedure 95% of the time with great results, and highly satisfied patients. The reason why this procedure is so successful is because it preserves nipple sensation, appearance and function.
A large nipple reduction can be done under local, but most patients prefer to have it done under general anesthesia.