Nipple and areola surgery is a plastic surgery procedure that alters the size and/or appearance of the nipples. It can be performed on both men and women, and it seems to be growing in popularity. There are several types of nipple surgery, including nipple reduction, nipple reconstruction, nipple augmentation and nipple repair. Nipple surgery can also be performed to reduce the size of the areolas (the darker pigmented areas around the nipples).

This surgery is often performed during or after breast augmentation, breast lift or reconstructive surgery. If you are concerned about the appearance of your nipples, schedule a consultation with a board-certified plastic surgeon to discuss these issues. After a thorough examination, your surgeon can help you decide which nipple surgery, if any, can best address your concerns. 

The best candidates for nipple surgery include individuals with:

• Asymmetric nipples
• Inverted or indented nipples
• Enlarged nipples
• Enlarged or puffy areolas

The Nipple Surgery Procedure

Your surgery may be performed at a surgeon’s office, an outpatient surgery center or a hospital. Time in surgery is about one hour. The procedure may be performed under local anesthesia unless it is combined with another procedure. Normally you will return home the same day. You will likely need someone to drive you home after the procedure.

The specifics of your nipple surgery will depend on what aspect of your nipples’ or areolas’ appearance requires correction.

An incision is typically made in the nipple or areola. If you are undergoing nipple surgery to treat an enlarged nipple, some excess skin may be removed. Nipple reduction surgery can shorten nipple length, width or both.

If your nipple surgery is being performed to repair an inverted nipple, your surgeon may craft an incision near the base of the nipple on the areola. From here, he or she will lift the nipple and areola tissue and stitch it into a new position.

Areola repigmentation, or nipple tattooing, is the use of micropigmentation to camouflage a scar or cosmetically enhance your nipples. It is often the final step following breast reconstruction surgery.

After Nipple Surgery

Nipple surgery recovery process will depend on the extent of your surgery, but it is usually short. Some swelling and bruising may occur. Bandages are applied to keep swelling to a minimum, and any discomfort usually subsides within a few days. Postsurgery pain is usually treated with prescription or over-the-counter pain medications. Your board-certified plastic surgeon will give you a complete list of medications that are and are not OK to take after your nipple surgery. Some pain medications may increase your risk of bleeding after nipple surgery and should be avoided.

You may experience nipple hypersensitivity after surgery, but this is usually temporary. Follow your surgeon’s instructions regarding when you can return to normal and strenuous activity, including sex. The full cosmetic results of this procedure may not be apparent for several months. Be patient.

Complications and Risks

Complications from nipple surgery are infrequent, but may include:

• Infection
• Bleeding
• Excessive bruising
• Hematoma (blood pooling outside of blood vessel that may clot)
• Nerve damage
• Scarring
• Dissatisfaction with the cosmetic results