Implants through the areola and nipple reduction at the same time? How will this impact sensitivity?

I have large nipples, and I know they will probably stretch to be even bigger after the augmentation, even though I only want to go up two cup sizes (34aa to a B cup). I would like to get my areolas reduced at the time of surgery, and was wondering if doing the implant through the nipple was a good idea, since the nipple will be worked on anyway. I'm also curious to know if losing nipple sensation is likely with periareolar implants with an areola reduction. Thanks!

Doctor Answers 3

Nipple sensitivity

Thank you for your question.  Breast augmentation through an areola incision with areola reduction may cause a change in sensation, albeit usually temporary.  If it occurs, it usually resolves in a couple of months.  Be sure to consult with an experienced board certified plastic surgeon for your surgery.  Good luck.

Dallas Plastic Surgeon
5.0 out of 5 stars 19 reviews

Implants through the areola and nipple reduction at the same time? How will this impact sensitivity?

Placement of the implants through the areola (periareolar incision) can easily be done unless the patient is asking for very large implants - which you are not. The areola can be reduced at the same time. Nipple sensation is generally not permanently affected, although some temporary hyper or hypo sensitivity is not unheard of. 

David Dellinger, DO, FACOS
Austin Plastic Surgeon
5.0 out of 5 stars 21 reviews

Nipple Sensitivity Impact

Dear rnj8897,
Considering your goals what I would recommend patients in my practice do is use an incision along the lower breast fold to place the implants in the submuscular position and then do an additional incision to reduce the areolae with a periareolar incision. The reduction of the areolae should be done with a permanent suture such as Gore-Tex which is resistant to infection and also permanently holds the reduction in place. If you do not use a permanent suture then a year after the operation when the absorbable suture is gone the areolae will spread out quite wide once again. Doing the areolae reduction in this manner should not have any influence on reduction of sensation of the nipples. On the other hand, if the periareolar incision is used to go dissecting through the middle of the breast the chances of nipple numbness go up considerably. In addition, pulling the implant through the breast tissue increases the chances of implant hardening in the next year. Implant hardening or capsular contracture is related to bacteria normally found on the skin or within the breast implanting on the implant and causing a low-grade chronic inflammatory process that results in hardening of the implant. That is why I follow the studies that show placement of the implant through the fold incision has a much lower hardening rate and would be worth the additional, though barely perceptible scar. I hope this has been helpful. Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

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.