Nipple & Areolar Correction in Sydney

Cosmetic breast surgery is not limited to breast enlargement or reduction procedures. Nipple and areolar correction refers to a group of surgical procedures designed to alter the nipple, the areola or both. These procedures can address variations in size, shape, position and projection of the nipple-areola complex (NAC).

Dr Ellis Choy is a Specialist Plastic Surgeon based in Sydney who performs nipple and areolar surgery. To request a consultation, enquire here.

Understanding Breast Anatomy and Aesthetics

To understand what takes place in nipple and areolar procedures and why some patients seek them, it helps to be familiar with basic breast anatomy and the proportional relationships considered in aesthetics.

The breast is made up of the following features:

• Nipple: the central projecting structure
• Areola: the circular area of pigmented skin surrounding the nipple
• Nipple-Areola Complex (NAC): the nipple and areola together as a single unit
• Breast Mound: the main body of the breast tissue

When we look at the breast through an aesthetic lens, we rarely consider these structures individually. Breast aesthetics are more strongly determined by the harmony between these components. The key relationships include:

• Nipple vs. Areola: the size and projection of the nipple are typically viewed in relation to the diameter of the areola
• NAC vs. Breast Mound: the overall size of the NAC and its position on the breast mound are considered relative to the breast’s total volume, shape and dimensions

Variations in these proportions are common. They can be present from birth or develop due to factors such as pregnancy, breastfeeding, significant weight fluctuations, ageing or the effects of previous breast surgery. 

The Benefits of Nipple and Areola Surgery

Nipple and areolar surgery can address a range of conditions, including:

Inverted Nipples

This describes nipples that point inwards rather than project outwards. Inverted nipples appear flattened or as though they sit below the level of the areola. The degree of inversion can range from mild (nipples can be stimulated to protrude) to more severe (nipples remain retracted). 

Areola Size

Some individuals have areolas that appear disproportionately large relative to the overall size of their breast mound.

Asymmetry

This refers to noticeable differences between the left and right NAC in terms of size, shape or position on the breast mound. Minor asymmetry is very common, but more significant differences can be addressed surgically.

Nipple Size, Shape or Projection

Variations can include nipples that are considered overly long, wide (“hypertrophic”) or have a “puffy” appearance where the nipple and areola seem to project forward excessively due to underlying tissue. This is often observed in Asian populations.

Post-Reconstruction Needs

Following mastectomy and breast reconstruction, surgery to recreate a nipple and areola is often the final stage in restoring a more complete breast appearance.

Surgical Techniques for Nipple and Areolar Correction

Dr Choy utilises various surgical techniques tailored to the anatomical variation being addressed. He will discuss the options available to you during your consultation.

Techniques for Inverted Nipple Release

Depending on the degree of inversion and whether preserving breastfeeding function is a possibility, techniques may involve releasing the fibrous bands pulling the nipple inward and sometimes dividing underlying milk ducts. Sutures are often used internally to support the newly projected nipple position.

Techniques for Areola Reduction

The most common method involves removing a ring of pigmented skin from the outer border of the existing areola (circumareolar or “donut” incision). The remaining areolar skin is then sutured to the surrounding breast skin to create a smaller areola. 

Techniques for Nipple Reduction/Reshaping

To reduce nipple length or width, techniques may involve removing small wedges of tissue from the nipple shaft or base (wedge excision) or flap techniques that aim to preserve blood supply and sensation.

Techniques for Improving Symmetry

Correcting asymmetry often requires combining different techniques. Dr Choy customises the treatment plan based on what each individual nipple and areola needs to achieve a better match in size, shape and position.

Techniques for NAC Reconstruction

Creating a new nipple often involves using local skin flaps from the reconstructed breast mound. Areola reconstruction typically uses skin grafts or medical tattooing to recreate the pigmented area.

The Relationship Between the NAC and Other Breast Procedures

The appearance and position of the nipple-areola complex are intrinsically linked to the shape, volume and position of the underlying breast mound. Therefore, addressing concerns about the NAC sometimes involves considering the breast mound as well.

Procedures that primarily alter the breast mound fundamentally change the canvas upon which the NAC sits. For example:

• A breast lift elevates the breast mound. The procedure often involves repositioning the NAC higher on the chest wall and resizing the areola for proportion.
• Breast reduction surgery removes excess breast tissue and skin. The NAC is often resized and repositioned to remain proportionate with the smaller breast volume.
• Breast augmentation increases breast volume, which can subtly alter the perceived size or position of the NAC. NAC adjustments might be considered to suit the new breast size.
• Tuberous breast correction addresses a breast shape anomaly featuring a constricted base that often causes the areolas to appear disproportionately large. Reshaping the breast mound can improve areola proportion, although direct areola resizing/reshaping is also commonly done concurrently.

During your consultation, Dr Choy will assess your complete breast anatomy, both the NAC and the breast mound. This comprehensive assessment helps determine the most appropriate surgical plan based on your anatomy and goals. 

What to Expect When You Have a Consultation With Dr Choy

The first step in any cosmetic surgical procedure is to employ the services of a highly qualified and experienced practitioner, like Dr Ellis Choy.

Dr Choy is a Specialist Plastic Surgeon with decades of training and experience. He pays careful attention to his patients’ needs and concerns and will discuss your expectations and goals in detail during a private consultation. Dr Choy uses state-of-the-art equipment in a purpose-designed clinic to provide an enhanced experience for his patients.

Dr Choy will thoroughly review any medical history or medications used that could influence the outcome of the procedure. His recommendations are tailored to individual patient needs, all provided in a caring spirit. Your areolar or nipple surgery cost is dependent on the procedure required, and will be fully appraised as part of the consultation.

How Is Nipple or Areolar Surgery Performed?

Nipple or areolar correction surgery is generally performed on an outpatient basis. The procedure takes approximately one hour, although if combined with additional procedures the surgery will take longer.

A nipple reduction or correction of an inverted nipple is performed by making an incision on the nipple. Inverted nipples are relatively common, with one in fifty women experiencing this condition. Reversing an inverted nipple is performed by spreading the fibres that pull the nipple inward. The nipple can then be freed and will face outward.

Nipples that are long or droopy can be reduced in length so they are more proportionate. Wide nipples can be reduced by removing some of the underside of the nipple, and the circumference can be reduced.

Areolar reduction involves an incision around the areola. Some pigmented areas can then be removed, creating a smaller circumference in keeping with overall breast shape.

What Should I Expect After Surgery?

Although nipple and areolar surgery is less invasive than many other cosmetic breast surgeries, there will still be some swelling and discomfort after the operation. Pain medication can be prescribed by Dr Choy, and any incision areas will need to be protected with gauze dressings and a surgical bra if required. This will keep the breasts in proper position during the healing process.

Return to work or regular activities is usually possible within a day or two, although strenuous exercise should be avoided for two to three weeks. You will be able to drive a day or two after the operation, and any numbness experienced should diminish over the next few weeks. 

Final results become apparent as residual swelling resolves and tissues settle, which can take six to 12 months. The results are permanent outside of natural changes that occur with ageing and life events like pregnancy or weight fluctuations.

Nipple and Areola Correction FAQ

Can I breastfeed after this type of surgery? 

The ability to breastfeed may be affected depending on the technique used. Techniques that involve dividing milk ducts will prevent future breastfeeding from the affected nipple(s). Procedures that preserve the milk ducts may allow for breastfeeding, but this cannot be guaranteed. This is a critical point to discuss with Dr Choy during your consultation.

Will my nipple sensation be permanently affected? 

Changes in nipple and areola sensation are possible following these procedures. This can manifest as increased sensitivity, decreased sensitivity or numbness. While sensation often gradually improves over several months as the nerves recover, you should be aware that some degree of permanent change in sensation can occur. 

What are the risks?

While Dr Choy takes every precaution to minimise risks, it is important to be aware of them. These include, but are not limited to:

• Infection
• Bleeding (haematoma)
• Adverse scarring
• Asymmetry
• Changes in nipple or areola sensation (temporary or permanent)
• Difficulty or inability to breastfeed (depending on technique)
• Need for revision surgery
• Risks associated with anaesthesia

Dr Choy will discuss these risks in detail during your consultation, relevant to your health status and the planned procedure.

What is the cost of nipple and areolar surgery?

Costs depend on the specific procedure performed, the complexity, surgical time required, anaesthesia fees and hospital/facility fees. A personalised quote is provided after your consultation.

Am I a candidate for nipple or areola surgery?

Suitability is determined on an individual basis during a consultation with Dr Choy. Generally, candidates should be adults (typically 18 years or older) whose breast development is complete, be in good overall physical health, and preferably be non-smokers or willing to quit smoking well before and after surgery. 

Discuss Your Options With Dr Choy

Dr Ellis Choy is a fully qualified Specialist Plastic Surgeon with extensive experience in breast surgery. During your consultation, he will assess your anatomy, listen to your goals, discuss whether nipple/areolar surgery is appropriate for you, and explain the benefits, risks and expected recovery process in detail.

Enquire here to schedule a consultation with Dr Choy or to request more information about nipple-areolar correction procedures.