Plastic surgery procedures can be used to address variations in nipple size, shape, or position. This may involve reducing the height and width of a nipple, or correcting nipple inversion where the nipple is flat or turned inward.
Inverted nipples
Some people are born with inverted nipples and may feel self-conscious about this normal variation. A previously projecting nipple that becomes inverted should be medically assessed, as it may indicate an underlying condition, including breast cancer. Nipple inversion can also make breastfeeding more challenging.
Nipple inversion is categorised into varying degrees of severity, with different surgical or non-surgical approaches suited to each level. Dr Amira Sanki (MED0001186186) and Dr Ilias Kotronakis (MED0001182552), both Specialist Plastic Surgeons (FRACS Plast), discuss treatment options according to the cause, severity, and patient goals.
Surgical correction of nipple inversion is usually performed as a day procedure. The operation typically leaves small scars on the areola, which may fade over time, although scar appearance varies between individuals. An explanation of causes and treatment options is available in an excerpt featuring Dr Sanki from the program “Embarrassing Bodies Down Under.”
Medicare and private health insurance may cover nipple inversion surgery where medical criteria are met. This may include coverage for hospital and theatre fees.
Protruding nipples
In some individuals, nipples are proportionally larger than the surrounding breast tissue and may project through clothing. This can occur in both women and men. Nipple reduction surgery aims to reshape the nipple to a size proportionate to the breast mound. This is performed as a day procedure. A padded dressing is worn for 7–14 days, and dissolving stitches are commonly used. Resulting scars generally fade over time, but healing outcomes vary.
What to expect at your first consultation
A consultation will address your concerns, goals, and relevant medical history. A general breast examination is performed, including a review of family breast history. Your surgeon will discuss appropriate treatment options, provide written information, and explain the benefits and risks of surgery. A follow-up consultation can be arranged if further questions arise.
What the procedure involves
Procedures are performed in licensed hospital facilities. Correction can be done on one or both nipples. Incisions for nipple reduction are placed within the natural grooves of the nipple. Tissue wedges may be removed to reduce size in height, width, and projection.
For nipple inversion surgery, small incisions are made in the areola to access and release tethering milk ducts beneath the nipple. Sometimes additional sutures or small skin flaps are used to help maintain nipple position. Dissolving stitches are used in both types of procedures.
After the surgery
Local anaesthetic is used during surgery, which may keep the nipples numb for several hours afterwards. Ice packs are applied in recovery to help reduce swelling. Waterproof dressings are typically used, allowing showering the following day.
Combining Procedures
Nipple surgery can be performed alongside other breast operations, such as augmentation, lift, or reduction, if appropriate for the patient’s overall surgical plan.
Hospital Stay
When performed alone, nipple procedures are usually day surgeries. If combined with larger breast procedures, an overnight stay may be recommended.
Pain and Sensation
Discomfort after surgery varies but is often described as numbness, swelling, or bruising. These sensations generally resolve over one to three weeks.
Driving After Surgery
Driving is usually possible after approximately one day, provided you are not taking strong pain relief and can check blind spots safely.
Returning to Work and Exercise
Return to work is often possible within a few days. Gentle exercise may resume after one week, with heavier activity from around four weeks.
Hospitals Where Surgery is Performed
Procedures are carried out at accredited private hospitals, including St George, Hurstville, Bondi Junction, and St Luke’s. These facilities provide the required surgical and anaesthetic support for such procedures.
All-Female Surgical Team Availability
For those who prefer, Dr Sanki can arrange an all-female surgical team for certain operating lists. Team members are selected for their qualifications and skills.
Private Health Insurance
Nipple reduction is generally considered a cosmetic procedure and is not covered by Medicare or private health insurance. Nipple inversion surgery may be eligible for cover under Medicare item number 31563, if medical criteria are met.
Who Should Perform Nipple Corrective Surgery?
These operations involve real surgical risks and should be performed by an appropriately qualified surgeon. In Australia, Specialist Plastic Surgeons have completed FRACS (Plast) training in Plastic and Reconstructive Surgery, which is a standard qualification to perform such procedures in both public and private hospitals.
Dr Amira Sanki and Dr Ilias Kotronakis are Specialist Plastic Surgeons, Australian-trained, and members of the Australian Society of Plastic Surgeons. Dr Sanki has also held the role of Chair for Education with the Australasian Society of Aesthetic Plastic Surgeons. They have experience performing nipple corrective surgery and use techniques discussed with patients according to their needs and goals.
Plastic surgery carries risks, including infection, bleeding, changes in nipple sensation, delayed wound healing, asymmetry, unfavourable scarring, and anaesthetic complications. Your surgeon will explain the risks most relevant to you, in the context of your health and the specifics of your surgery.
1. Infection: Any surgical procedure has the risk of infection. Surgeons take precautions to minimise this risk, such as sterile operating environments and proper wound care, but infections can still occur.
2. Scarring: Scarring is an inherent risk of plastic surgery. While surgeons strive to minimise visible scarring, some procedures may result in more noticeable or keloid scars.
3. Pain and discomfort: Plastic surgery involves incisions and tissue manipulation, which can lead to post-operative pain and discomfort. The level of pain varies depending on the procedure and the individual’s pain tolerance.
4. Hematoma and seroma: Hematomas are collections of blood that can form under the skin after surgery, while seromas are collections of fluid. These fluid collections may require drainage.
5. Nerve damage: Nerves can be damaged during surgery, leading to temporary or permanent numbness, tingling, or loss of sensation in the affected area. Nerve damage can also cause muscle weakness or paralysis.
6. Blood clots: Surgical procedures carry a risk of blood clot formation, particularly in the legs. Blood clots can be serious if they travel to other parts of the body, causing complications like pulmonary embolism.
7. Anesthesia risks: Plastic surgery usually requires the use of anesthesia, which carries its own set of risks. These include adverse reactions to anesthesia, breathing difficulties, and, in rare cases, life-threatening complications.
8. Unsatisfactory results: Plastic surgery outcomes may not meet the patient’s expectations or desires. It’s important for individuals to have realistic expectations and to communicate clearly with their surgeon about their goals and desired outcomes before undertaking a breast reduction in Sydney.
9. Revision surgery: In some cases, additional surgery may be required to achieve the desired results or to correct any complications or unsatisfactory outcomes. This can increase the financial and emotional burden on the patient.
10. Psychological and emotional effects: Plastic surgery can have psychological and emotional impacts, both positive and negative. While many people experience improved self-esteem and body image after surgery, others may struggle with unrealistic expectations, body dysmorphia, or dissatisfaction with the results.
11. Loss of nipple sensation: most people become either hypersensitive or numb after surgery. This improves after a few weeks. Some people will experience numbness that does not improve (approx. 5%).
12. Asymmetry of the breasts: No two breasts are the same. The goal of surgery is to improve symmetry but absolute symmetry cannot be achieved.
13. Cup size cannot be guaranteed: breast reduction surgery lifts and reduces the size of the breasts. Your surgeon will speak to you about the approximate size you would like to achieve to suit your frame and body.
14. Recurrent breast growth or sag: your breasts will continue to change shape and size if you fall pregnant, breast feed, gain or lose weight.
It’s crucial for individuals considering plastic surgery to consult with a qualified and experienced plastic surgeon who can thoroughly explain the risks and benefits specific to their desired procedure. Understanding and carefully weighing these risks against the potential benefits can help individuals make informed decisions about whether to proceed with plastic surgery.