Nipple Correction

The Operation: What Happens during Surgery?

Nipple correction surgery is a relatively speedy procedure and can take as little as half an hour but usually lasts around one hour.  It is carried out mostly under local anesthesia and sedation, which means you’ll be awake but relaxed.  You may require a one-night stay in hospital so you can be monitored and to assist you if you have undue pain or discomfort.  Some people feel able to return to their accommodation within hours. 

The surgery falls into two main types:

Nipples correction with the milk ducts partially in tact

The surgeon makes small incisions around the bottom of the nipple on the areola.  The nipple and areola is raised, with tissue and milk ducts connected, and then stitched back into place with the skin drawn to pull the nipple upwards, outwards and into its natural position.  The milk ducts remain in tact or partially in tact in this procedure.

Nipple correction with milk ducts severed

This is the more common intervention and it is required in more drastic cases of nipple inversion.  After making the incision below the nipple in the areola, the surgeon then cuts the shortened milk ducts to ‘release’ the nipple into its natural position.  The nipple is then repositioned.  It is usually still attached to its blood supply though in some surgery it will have been removed and skin grafted back in place. The surgeon will endeavour not to take this route as it means you will lose nipple sensitivity.  This is something you need to discuss at consultation stage in detail. 

If this procedure is carried out, you will not be able to breast feed. 

In both procedures, the incision is cleaned and dressed with light gauze. 

Recovery / Convalescence

If the operation is carried out under local anesthetic, you may feel able to return to your accommodation within hours.  Most people can expect to feel up to returning to work within a few days.  But you need to allow a week, perhaps even longer before you make plans as you will have some immediate, though slight, swelling and  bruising.  This is alleviated with regular, over-the-counter pain relief medication.  You may be prescribed antibiotics in the first weeks to prevent risk of infection (sometimes, the milk ducts can become infected).

You will have light dressings in place for up to two weeks.  Take care not to get your nipples wet during this time.  You will have post-operative information to guide you on bathing, exercise and so on.

Stitches are usually absorbable sutures and dissolve within around one week to 10 days.  You will have scarring, though usually minimal as the incision points were within the darker skin of your areola. 

It’s advisable to wear comfortable bras – soft support bras without under wiring – for the first weeks. 

You should refrain from any strenuous activities especially lifting or sports for six weeks.  You will be advised of when you can take up certain sports and exercise again. 

You can aid your recovery by: 

• Applying ice packs (or packets of frozen vegetables wrapped in towels) to your chest immediately after surgery if you have swelling.
• Rest and sleep with your upper torso elevated.
• Keep breast skin supple by applying moisturizer, though carefully avoid the wounds
• Do not do any exercise or take up activities that can strain you – avoid bending and lifting for instance
• Do not get your chest wet in the shower or bath for up two weeks
• Wear loose, light clothing preferably in natural fibres

Safety

Nipple correction surgery is a very common and highly successful procedure, but as with all cosmetic surgery, there are risks from the surgery itself and from any complication which might arise.  You may also feel that the outcome is not what you intended.  There are no guarantees in cosmetic surgery, but rest assured that the majority of people find the benefits are long term and they feel psychologically better having opted for it.   Most complications are temporary and relate to infection (in breast ducts or scar tissue) or are due to pain and swelling. 

All cosmetic surgery carries the risk of:

• Infection
• Allergic reaction to anesthetics or analgesics
• Lack of wound healing (excessive bleeding – hematoma)
• Blood clot (possibly deep vein thrombosis, or cardiac or pulmonary risk)
• Fluid accumulationOngoing, excessive pain
• The need for further, possibly corrective, surgery
• Absorbable sutures causing skin ruptures and uneven healing of the scar tissue

What are the risks in Breast Reduction surgery?

Scarring

Scars occur around the nipple in the areola. They should fade to be barely noticeable within around six months to a year.  At first, scars will be pink and slightly raised.  If you notice they heal over the longer term in ridges (keloids), consult your surgeon as you may need minor corrective surgery.  You may also find that your breasts are red and hot and some leakage occurs from the scars.  Consult your surgeon should you see this sign as you may need antibiotics.

Sensitivity of Breasts

It is common to have a different sense of feeling in your nipples after the operation.  Various parts of your breast will feel either more or less sensitive than before.  If you experience numbness, this can be permanent due to the severing of nerve endings or loss of blood supply that may have occurred during surgery.  In rare cases, part of the nipple’s underlying fat tissue may die, and you will lose sensation.  This is more likely to happen if you are a heavy smoker or have poor circulation, as the blood supply will not be sufficient to ‘feed’ the nipple area.

Breast Feeding

It may not be possible to breast feed after your operation, depending on the type of surgery involved.  You will need to discuss clearly with your surgeon at your consultation the likelihood of breast feeding post your operation.