Improving Nipple Appearance: Too Big, Too Little, Irregular

Occasionally patients come to Dr. Graham with questions about whether something can be done to make their nipples look more normal.  That brings on the discussion of what is normal nipple appearance for a woman.  The variety is great.  Some are less than one-half inch across, centered in the areola, about three-eights inch tall, and uniform in texture.  Many are shorter or longer than this.  Some of the longer ones are thin or empty, others are uniform in thickness.  The shorter ones may be simply less distinct or may be inverted; turned inward.  Our patients sometimes report that their nipples changed over time, or because of pregnancy or breast feeding. 

Elongated nipples can be reduced to obtain a size of the patient's choice.  On the other hand, inverted nipples can be corrected; actually turned out.  Irregular nipples can often be modified.  These procedures are often done under local anesthesia as an office procedure, or combined with more involved breast procedures.  The scars are barely visible.  The recovery period is brief.  Nipple procedures may interfere with breast feeding, so it may be recommended to wait for young women.

The size and shape of the areola around the nipple is very diverse.  Some areolas are very large relative to the size of the breast.  Areola reduction procedures can be done, removing excessive pigmented skin around the nipple.  This is often called "doughnut mastopexy", referring to the concentric bit of skin removed around the outer areola.  Lifting the nipple and areola to a higher location on the breast, or lifting them along with the breast itself involves other mastopexy (breast lift) techniques. 

And finally there are male patients who have unusual appearance of the nipples that can be corrected.  Frequently, the breast tissue beneath the nipple and areola is overgrown, a conditon called gynecomastia.  Removal of the overgrown tissue can improve male chest appearance and reduce prominent nipples.  If only the nipple is involved, a small reduction procedure under local anesthesia may be all that is needed. 

All these recommndations presume that the patient is otherwise healthy and normal.  Proper evaluation would check for breast cancer, skin tumors, etc. before recommending procedures to enhance one's appearance.