Advanced Art of Cosmetic Surgery     Thomas M. DeWire, Sr., MD, FACS    Specializing in Cosmetic Plastic Surgery     Richmond, Virginia, USA




  Advanced Art of Cosmetic Surgery:  Thomas M. DeWire, MD, FACS, Surgery Center and Spa,  3974 Springfield Road, Glen Allen, VA, 23260, Richmond, Virginia, USA

Non-Implant Breast Surgery Procedures

Nipple Reduction and Shaping



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Nipple Reduction and Shaping:

Nipple reduction  is a technique used for reshaping nipples that are elongated or overly-projecting,  and thus often tend to fold over, and sometimes hang downward.  Excessive nipple diameter, or girth can also be corrected as shown below.  This situation is most often seen in  women  with  small breasts,  and a small  diameter areola.  The  cause may  be developmental,  or may be a consequence of  breast-feeding.  Correction generally results in no visible scarring and no change in the nipple sensitivity, and since the milk ducts are not disrupted in any way,  patients can even successfully breast feed after this type of nipple reduction procedure.



Photos Before and After Surgery:


Case 1:    A  38-year-old with a history of 3 pregnancies and breastfeeding underwent trans- axillary breast augmentation and bilateral nipple reduction to address small breast volume and nipple redundancy with folding.  See close-up at far right.
Close-up photos show the very inconspicuous scar at the base of the right nipple at the junction with the areola. Scarring is usually very minimal because the tissue of the nipple and areola is very similar to the tissue of the lips, which also tend to scar minimally in most patients. 
Case 1 continued:

Composite before and after views of the patient shown above for reference.  Bilateral 250cc saline moderate profile Mentor implants were used with split fill volumes of 275cc left right and 250cc left to achieve a C-cup result in a patient who is 5' 4" and 121#.

Case 1 continued:

Oblique views of the same patient showing excellent  shape and symmetry and resolution of the nipple redundancy


Case 2:  A 46-year-old Asian female with one pregnancy and  breast-feeding underwent breast implant augmentation and nipple reduction to correct redundancy and nipple droop. Close-up operating room photos at the bottom show the status before and after the nipple reduction, and the photo at far right shows the minimal scarring in the mature result at 3 months. The tissue that is removed is taken from the base of the areola, and involves skin only so that nipple sensation and function is preserved.


Case 3:  A 42-year-old after two pregnancies with breastfeeding underwent breast enlargement with implants and a complex nipple reduction to address both elongation and excessive distal nipple diameter and bulk with sag of the nipples and asymmetry. The nipple was shortened by removing full thickness skin at the base and wedge resection of the distal nipple along the long axis to correct nipple shape and bulk. 
Case 3 continued: The length and diameter of both nipples was corrected in this instance, restoring normal nipple geometry, proportion, and perkiness.


Case 4:   A 33-year-old with two pregnancies and breastfeeding is shown before and after breast implant placement with bilateral nipple reductions to address excessive nipple length and redundancy with folding over of the nipples.  Results are shown 6 weeks after the surgery.


Case 5:   A  43 year old woman  is seen in three views, pre-op, after trans-ax augmentation,    and after nipple reduction, done at a later date.  Close-ups of the results  of  nipple reduction are  shown below. 
Although a very small scar results around the base of the nipple at the junction with the areola, the scar is virtually never visible. Pre-op and post-op photos  of nipple-areola  complexes in close-up  to  show  detail.
Oblique views of the same  patient showing results of  the nipple reduction procedure.  


Related  Breast Augmentation Links:   To Other photo Illustrated Procedures:

Important  Information  About  Implant  Breast  Enlargement

Trans-Axillary Breast Augmentation
Trans-Axillary Breast Incisions Scars
Breast Augmentation Shape Evolution
Breast Augmentation Shape Determination
Cleavage Determinants
Post-Op Implant Massage Technique
Implants Over versus Under the Muscle
Special Considerations in Augmentation
Breast Surgery in African American Women
Breast Augmentation FAQs
Breast Augmentation with Mastopexy or Breast Lift
Revision Surgery for Augmentation Problems
Important Information about Silicone Breast Implant Use
Nipple Reduction/Shaping
Mastopexy or Breast Lift

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Thomas M. DeWire, Sr., MD, FACS
Advanced Art of Cosmetic Surgery
3974 Springfield Road
Glen Allen, VA 23060
Richmond, Virginia, USA
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ęCopyright 1997-2013  Advanced Art of Cosmetic Surgery:  Thomas M. DeWire, Sr, MD, FACS   Revised:   September 09, 2014 06:03 PM