Nipple Reduction to Improve Scars and Shape?

I am 52 and had a breast uplift with 170cc silicone tear drop implants partially submuscular. There is a slight pleat near the bottom cleavage side of each breast. My nipples also look larger than before and the scar around it is still red after 12 months. If I lightly pinch the nipples without pulling them, the pleats disappear and the breast shape is improved. Can nipple reduction help improve the aureola scars and breast shape? The breasts are otherwise soft and natural looking.

Doctor Answers (5)

Nipple Reduction to Improve Areolar Scars?

+1

Generally speaking, nipple reduction surgery is not useful for the purposes you describe;  I think you will be best off seeking advice directly from your plastic surgeon demonstrating the phenomenon that you describe in your question. Otherwise, circumareolar scar revision may be helpful.

Best wishes.


San Diego Plastic Surgeon
5.0 out of 5 stars 793 reviews

Nipple reduction and mastopexy scars

+1

I fyou have unfavorable pleating scars aroudn your areolas, they will not improve from just a nipple reduction. It sounds like those scars may need to be revised.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Widening of the areola / nipple with Poorly Chosen Breast Lift / Augmentation

+1

Regarding: "Nipple Reduction to Improve Scars and Shape?
I am 52 and had a breast uplift with 170cc silicone tear drop implants partially submuscular. There is a slight pleat near the bottom cleavage side of each breast. My nipples also look larger than before and the scar around it is still red after 12 months. If I lightly pinch the nipples without pulling them, the pleats disappear and the breast shape is improved. Can nipple reduction help improve the aureola scars and breast shape? The breasts are otherwise soft and natural looking
."

From your description, it sounds as if you had a Breast Augmentation and lift through a periareolar (around the areola) incision. Removing a donut of redundant skin as the mechanism of lift then has to match a wider outer circle of remaining breast skin with the smaller circumference of the areola; This results in outward pulling and an enlargement of the areola (as you have already noticed). In addition, stitching the mismatched circles results in scalloping, irregularities and occasionally in a "Sun Burst" scar around the areola.

The periareolar lift (such as a Benelli) should ONLY be used in very mild sagging. Unfortunately, some surgeons are pushed into using it in more advanced sagging resulting in the findings you describe. Removal of a pinch of skin will be a very short term solution as it will result in increased tension on the wound and a widespread periareolar scar. A better option would be either to use a smaller implant OR to convert the lift to a lollipop shaped lift taking the tension off the areola.

The reason for the pleating is most likely the fact that your implant is not covered at the bottom of the pocket and you are seeing and feeling an implant pleat. Solutions here vary: from fat injections to cover the implant (with a high risk of implant perforation), to covering the bottom of the implant with an ADM such as Strattice with or without conversion to smooth walled gel implants which are less likely to show rippling.

Good Luck.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 66 reviews

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Nipple Rexuction?

+1
It sounds like you may have had a periareola lift. This may produce some pleating around the areola. This usually resiolves with time. Pictures in your case would be helpful. Dr. ES

Earl Stephenson, Jr., MD, DDS
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Large and pleaate areolae after breast lift and implant

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With pinching the nipple, you are most likely promiting contraction of the areola which is likely to soften the pleats or wirinkles you describe. However, I am not cerain that surgery is the cure for these. I would still give it time.

Otto Joseph Placik, MD
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.