I have very large protruding nipples and a smallish areola. After breastfeeding, they started to droop and now look worse. I would like to have a breast augmentation, preferably with an areola incision, could I also have my nipples reduced in length and width at the same time? Or would it cause too much stress or trauma on the area? I don't need a breast lift (if that matters) and according to the PS I saw during my first consult, my areola area is large enough for an areola incision. Thank you.
Is It Advisable to Have a Nipple (Not Areola) Reduction and BA at the Same Time?
Doctor Answers (26)
Nipple Reduction with Breast Augmentation
Reducing a nipple that is too long or too wide (or both) can be done as a matter of routine at the same time as breast augmentation.
Nipple reduction is possible
Nipple reduction is certainly possible at the same time as a breast augmentation, regardless of augmentation incision. The important fact to keep in mind is that lactation will be interrupted due to the inherent scarring. If you are planning on breastfeeding children in the future, you would want to delay this procedure. If you are terribly concerned with performing both procedures at the same time, the nipple reduction is simple to perform in the office at a later date under local anesthesia.
This is a reasonable combination though there are some theoretical concerns about increasing the bacterial exposure to the implant and possibly increasing the risk of capsular contracture.
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Nipple reduction and breast implant augmentation
This combination of procedures can easily be completed at the same operative session. Some surgeons have concerns about biofilm formatiion and transmission of bacteria through the lactiferous ducts.
Nipple reduction at same time as breast augmentation? Yes
I have performed exaclty this combination of procedures, and it works well. The nipple reduction really removes skin around the base of the nipple to reduce its height, so that's not terribly detrimental to its blood supply. If your nipples also require a change in diameter, then an addiitonal incision needs to be made to essentially remove a "pie slice" of the nipple and make it narrower.
I think the key to any blood supply problems (which could kill all or part of the nipple) is what size implant you choose. The larger the implant, the more stress on the blood supply.
If you want to take the most conservative route, you could easily stage these procedures. The breast augmentation could be done, then you could just have the nipple reduction done in the office under local anesthesia. I would go with whatever your surgeon is comfortable doing.
It is common
Breast Enhancement Surgery
Yes to Nipple Reduction
Nipple reduction is an easy, quick procedure to correct nipple hypertrophy. It can be performed at the same time of any breast procedure or on it's own as a local anesthetic in an office setting. I am surprised we don't perform more of this procedure.
With Warm Personal Regards,
David R Finkle, MD
Dealing with large areolas during a breast augmentation
An areolar reduction can be done at the same time of the breast augmentation. I will say though that when we are doing surgery, we desire to have the least amount of tension on the incision in order to get the best quality scar. Increased tension will potentially cause the scars to heal wider or thicker. In the performance of a breast augmentation, there is increased pressure on the areolar incision, so although it might heal well, you also might have a wider pinker scar. It might be best to do it at a second surgery, likely having it done under local anesthesia if the reduction in size is small.
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