Nipple Reduction Questions and Answers

Question:

I had a breast reduction consultation about 10 years ago. If you have a 36DD breast size, how is the nipple moved up to reduce the breast to 36B? Also, can anything be done about stretch marks on the breast?

Answer 1:

Dear Joan, The nipple and areola (dark area around the nipple) is moved up into a keyhole type of pattern. The lower portion is then closed in order to lift the breast. Tissue is removed from each side but carefully so as to maintain blood supply to the nipple and areola through the skin and also from the chest wall. Many stretch marks on the lower central portion of the breast would be removed with such surgery but stretch marks on the upper breast would remain.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Answer 2:

It is hard to describe a breast reduction via this format. I recommend that you go to www.plasticsurgery.org and click the info on breast reduction.

Question:

I have considered having a breast reduction. I had a consultation and was really scared off when I found out the nipple had to be removed. Obviously, no matter what anyone says, this loss of feeling will definitely affect ones' sex life.

Answer:

Dear Joan, Unfortunately, you received the wrong information. The nipple and areola (area around the nipple) is removed only in very rare cases of severely large breasts or in very old persons where operative time is a consideration. For the vast majority of women, the nipple and areola are moved upwards maintaining their blood and nerve supply. In large studies, 1/3 of women having the procedure had desreased sensitivity, 1/3 had no change and 1/3 actually had increased erogenous sensation.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Sir, I'm a 19 year old male, with a physical difformaty,(I believe it is anyway). I have very enlarged puffy nipples that stick way out and its hurting my self esteem and self image tremendously. What can I do about this. Thank you for your time.

Answer:

Dear Jeff, If it is just your nipples that are enlarged, you should look into nipple reduction surgery. This is straightforward and should be able to be performed by any well-trained plastic surgeon.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I wear a size D cup which i'm okay with but I have rather large nipples. Is there a procedure that can be down to reduce them? If so what is it called and how much does it cost? Thanks!

Answer 1:

Dear Kittie, Nipple and areolar (the dark skin around the nipple) reductions are commonly performed procedures by plastic surgeons. The cost is dependent upon the extent of the procedure by I would suspect about $1000 should cover the costs of the reductions depending upon extent. I would suggest that you visit with a plastic surgeon in your area to help with the decision.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Answer 2:

If you're nipples are large ( that is they stick out farther than you want) or your areola ( the pigmente area around the nipple) is too big, these are two different procedures. You should make clear to whichever doctor you choose to see, which of these is bothering you. Best of luck.

Josh Korman, M.D., F.A.C.S.
Mountain View, CA

Question:

I am a male of 21, and as long as I can remember, I have had enlarged nipples. This was quite embarassing throughout my teen years, however, now that I'm at the age that I can afford to do something, I want to know what can be done about this? Do I need surgery, or is there some kind of drug that I can take to reduce this? Thank you so much for any info you can give me, hopefully this can turn my life around and make me feel better about myself. Sincerely, Jerod

Answer:

Dear Jerod, That is what plastic surgery is all about. You do not mention if your breast size is larger than normal but I take it that this is mainly a problem with nipples or nipples and areolae (the dark area around the nipples). Both can be reduced very readily with minimal scarring and I would suggest that you visit with a plastic surgeon to explore this relatively common and safe way to improve your self esteem.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hello, I am 28 years and have never had any children. I have always had very large breasts (32 DD)but not had many problems with them. Recently they have grown to 34 D--DD. I had to discontinue using birth control pills as they were becoming excessively large and painful (34DDD). Now they also sag slightly. I have gained 10 pounds in the last three years, but I am still considered extremely light for my size (5'10") Most people wouldn't know that I have large breasts because I have adjusted my posture to hide them. Unfortunately, I was recently involved in a car accident and injured my neck. While recovering from the trauma, I placed increased strain on my upper back. Radiographs have shown osteophyte formation along several of my thoracic vertebrae. I am concerned that the excess weight of my cleavage is harming my back permanently. I have been seeing a chiropractor, physical therapist, and working on ergonomics, but am still having problems with my posture as well as severe back aches. I would like to have a breast reduction, but have a few concerns: 1. length of recovery, 2. extent of scars 3. cost 4. feasibility--is this really a size that should be reduced. 5. would insurance even consider paying for this procedure??? Thank you your time

Answer:

Dear Tonia, In your case I would certainly encourage you to seek breast reduction surgery. The recovery time will be about two weeks and the discomfort is rather minimal. Depending upon your insurance, a large portion of the procedure (which costs about $6000 or so) should be covered due to the physical problems that your large breasts are causing you. The scarring in your case would be around the areola (the dark area around the nipple), down the center portion of the breast and along the crease under the breast to a variable extent. I would suggest that you visit with a plastic surgeon in your area for input and to determine exactly the breast size that you would like following the procedure.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hello. I would like to know the best place of insicion for a breast augmentation, which limits the risks of a capsule contracture and loss of sensation in the nipples.

Answer:

Placement of the incision does not effect capsular contracture. Putting the implant under the muscle will reduce the likelihood of capsular contracture. An incision around the areoa is most likely to interfere with nipple sensation; putting the implant behind the muscle is also less likely to interfere with nipple sensation. Good luck Carmen Paradis M.D.

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