Nipples and areola (the pigmented area around the nipple) come in a range of shapes, colours and sizes, and there may be significant asymmetry between the two sides.
Sometimes, they are not proportionate to the rest of the breast. To make them more cosmetically appealing, they may need surgical reshaping. At times, it may even be necessary to reconstruct the whole nipple-areola complex from scratch when they have been removed due to breast cancer.
There are various surgical and non-surgical techniques that are used to change the nipple /areola to make them more proportionate to the rest of the breast shape. Two of the most common complaints are an areola that is too large or a nipple that is inverted.
Inverted nipples are usually a result of the ducts (milk channels) pulling the nipple in. This happens when the breast is developing but the ducts do not grow to the same extent. This can cause concerns for some women as they become self-conscious of the appearance of their breasts. This can usually be corrected with a simple surgical procedure – there are small scars but they heal well. Dr Safvat will discuss this with you and your plan for breastfeeding as it may be affected by the surgery. The surgery is done in an accredited hospital under a light anaesthetic and usually has very minimal downtime.
Enlarged areola can also be reduced. Dr Safvat uses a peri-areola incision (around the areola), which heals well with minimal scaring. This can be combined with breast reduction or breast lift to adjust the position or size of the breast as well. The recovery depends on the associated procedure (see section on Breast lift or Breast reduction) and will be discussed during your consultation.
Areola reconstruction surgery doesn’t usually take longer than an hour to complete but will require a light general anaesthetic. During the procedure, Dr Safvat will remove round piece of tissue from the areola. Since the incision is made along the border of the areola, scarring is barely visible. Your new areola will be secured with permanent sutures, which prevent it from stretching again. Dissolvable stitches will be used to close the areola incision.
Along with the complications associated with surgery in general, areola reduction can, in some cases, cause a loss of nipple sensation, scarring and problems with breastfeeding. Every possible measure is taken to keep risks and complications to a minimum. Dr Safvat will take you through his methods for doing so during your consultation.
The recovery period is relatively quick. While some bruising and swelling will be present, patients don’t usually need to take more than two days off work. Any discomfort can easily be managed using pain medication. A soft surgical or sports bra will need to be worn for several weeks and any physical movements that could affect the chest should be avoided for at least 3 weeks.
Once the swelling has subsided, the areolas will be both centred and smaller. The ring-shaped scar around each areola can take up to 12 months to recover and fade. If at any stage during your recovery you notice signs of complications and infection, contact us as soon as you can.
When a piece of the areola is removed, there is a chance that the milk ducts can be damaged. However, Dr Safvat takes every measure possible to prevent this from happening. Following areola reduction surgery, there is a small chance that you will be unable to breastfeed again in the future.
There are several different techniques that can be used to correct an inverted nipple. One of the most popular involves making an incision at the base of the nipple. This will help release any tension caused by the milk ducts. Once an anaesthetic is applied, the procedure usually won’t take longer than an hour to complete. Since this is a day procedure, no overnight stay is necessary.
After your procedure, a dressing will be applied to the nipple. Physical activity should be avoided for several weeks, particularly activities that could affect your chest. Bruising, swelling and discomfort can be expected after surgery but this won’t last long. Pain medication can help with any pain. Patients can return to work again within a day or two.
For 6 weeks, it’s also important not to apply any pressure to the nipple. Any scarring that’s present after surgery will subside over time, particularly if you apply the necessary scar management techniques.
Along with general surgical complications such as infection, re-inversion of the nipple is possible in a small number of cases. Unfortunately, this will require a second surgery to correct. There is also a chance that you might lose some nipple sensation. However, in most instances, any numbness does subside over the course of several months.
If you have an inverted nipple/s, you won’t be able to breastfeed. In terms of whether you will be able to breastfeed after surgery, this will all depend the technique that’s used.