The procedure of nipple reduction surgery is
to shorten the length of the actual nipples. This procedure
can be done under local anesthesia or combined with other breast
surgery. Shortening an overly
long nipple will generally not interfere with breastfeeding; however
there is still a risk that it might not be possible for some
patients to perform.
There are
several methods used by surgeons for nipple reductions, including
removal of just the top of the nipple, which is then closed with
tiny incisions. Another method is where the surgeon will
remove a band of areola skin around the base of the nipple, and
literally push the nipple back into the breast – in which it is then
sutured into place.
The biggest
risk with this procedure is losing the sensation in the nipple area
and also contributing to not being able to breastfeed. If this
procedure is not done in conjunction with another surgery, this can
easily be performed in the physician’s office with a local
anesthetic. Most patients have very little discomfort with
this procedure.
Swelling and
pain for the most part are minimal, and the results are almost
immediate. The nipple takes on a much more natural appearance
after the procedure and most patients will continue to have normal
sensation.
Inverted nipples that project inward instead
of outward, can affect breastfeeding as well as a patient’s
confidence level. The actual inverted nipple can take on an
appearance of a slit or a depression in the actual areola itself.
Inverted nipples are usually caused by shortened milk ducts.
Most of the time an inverted nipple is a cosmetic problem; however
it can also be a symptom of
breast cancer, so you should always have
this checked out. Surgical
correction of the inverted nipple transects the milk ducts and
breast feeding after this operation may be impaired.
Inverted
Nipple Grade I
– the inverted nipple is easily pulled out, and maintains it’s
projection without traction. Gentle finger pressure around
the areola or pinching of the skin area will cause the nipple to
pop back out.
Inverted
Nipple Grade II
– the inverted nipple can be pulled out, but not as easily as in
Grade I. After releasing traction, the nipple tends to
fall back and invert again.
Inverted Nipple Grade III– in this
grade, the nipple is severely retracted and inverted. It
is very difficult to physically force this nipple out and hold
it there.
This procedure
consists of a small incision at the base of the nipple while the
nipple is in a protected projected state. The surgeon then
does a spreading of the fibers which are pulling the nipple inward.
This has to be done with much care as the spreading of these fibers
parallel the milk ducts, in which all surgeons will go to great
lengths to preserve.
Once the
fibers are spread and the nipple is able to be freed from an inward
position, special sutures are placed actually inside the nipple area
to keep it from retracting back.
The biggest
risk to this procedure is trying to preserve the milk ducts so that
breastfeeding will be possible. Sometimes this is possible,
and other complex cases sometimes the milk ducts will actually
become detached. Make sure you communicate with your surgeon
what your goals are with breastfeeding in the future before
committing to this surgery.