Prominent Nipples is an uncommonly discussed problem experienced by both men and women. Lay people commonly describe the nipple as including the prominent protruding part of the breast as well as the darker circular rim of skin. Anatomically, the areola is the slightly darker skin surrounding the nipple proper. The nipple contains lactiferous ducts, a blood supply and sensory nerves. The nipple can be more prominent in men and women for genetic reasons or after breast feeding in women. In women, nipples are on average usually 8 mm high and 8 mm wide with a slightly rounded dome at the top. The normal range for women is from 6 mm to 11 mm. In men, nipples are on average 3-4 mm high and 3-4 mm wide and domed shaped at the top. The areola is significantly smaller in men, compared to women.
Nipples that are enlarged typically cause patients embarrassment because they can be visible through form fitting clothing. They can also be an issue for patients in intimate settings. Nipple reduction is frequently requested as part of a breast procedure such as breast augmentation, breast lift, or breast reduction. In men, it is commonly requested in conjunction with gynecomastia reduction. Some patients seek treatment for isolated concerns.
Several different surgical techniques have been described and all are quite successful. Scarring is usually minimal and not usually visible with time. The procedure is usually performed while having another procedure under anesthesia or can be quite comfortably done under local anesthesia in the privacy of the office. There are techniques that remove the top of the nipple (amputation) and others that remove the core of the nipple. Newer techniques spare the lactiferous ducts and nerves by preserving them. These advances allow patients to obtain their desired result without compromising the ability to breast feed or sensation.
Today, there is little information online regarding this procedure. There is a plethora of information on breast procedures in both men and women, but nipple reduction is still infrequently discussed. Patients with this problem should feel comfortable discussing this procedure with their Plastic Surgeon. They will be pleasantly surprised to learn how commonly we treat this problem. To learn more, please take a look at the youtube video graciously provided by one of our patients to better understand the procedure.
George Bitar, MD, FACS is an award-winning, board-certified cosmetic and reconstructive plastic surgeon, the Founder and Medical Director of Bitar Cosmetic Surgery Institute in Virginia. He specializes in the latest surgical and minimally invasive techniques to scar management and reduction. Dr. Bitar is involved in groundbreaking research and education in plastic surgery and has authored numerous articles, abstracts, and chapters.