Simple Surgical Technique Corrects Nipple Hypertrophy

A surgical technique for the modification of nipple hypertrophy provides reproducible, satisfactory, aesthetic results with minimal tissue manipulation.

Researchers at the University of Texas Medical Branch (UTMB; Galveston, USA) developed the nipple amputation technique to correct nipple hypertrophy, which is based on a horizontal incision through the distal portion of the nipple (in the nonerect state) to remove the predetermined nipple height. After nipple amputation, epinephrine-soaked gauze is applied to the surgical site for 5 minutes, followed by a postoperative dressing of nonstick gauze with antibacterial ointment. Subsequent reepitelialization by epithelial migration from skin glands covers the end of the nipple. The technique was performed in 30 consecutive patients from 2000-2010; in 29 of the 30 patients, simultaneous breast procedures were also performed, primarily breast augmentation.

The results showed that all patients (29 women and 1 man) reported being satisfied with the procedure. Three patients noted decreased sensation, one noted a size discrepancy requiring further surgical intervention, and one noted persistent oozing from the surgical site on the postoperative day. One patient who became pregnant postoperatively was able to lactate in the postpartum period, but was not able to produce enough milk bilaterally to perform breastfeeding. The study was published in the November 2012 issue of Aesthetic Surgery Journal.

“This simplified surgical technique for correction of nipple hypertrophy was easy to perform, both alone and in combination with additional surgical procedures, and provided reproducible, satisfactory aesthetic results,” concluded lead author Prof. Clayton Moliver, MD.

Nipple reduction surgeries are often considered for those women with large or overly prominent nipples and are often performed in conjunction with breast augmentations and mastopexies, which can alter the aesthetic proportionality between the nipple, areola, and breast. Several techniques exist to correct nipple hypertrophy, yet the majority of the procedures traditionally used can result in scarring of the nipple, decreased nipple sensation, disruption of the innervating intercostal nerves, or blockage of the 16-24 lactiferous ducts housed in the central portion of the nipple.

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University of Texas Medical Branch