Breast Augmentation Nipple & Areolarplasty

This patient has very small breast and after breast feeding 4 children she was concerned about her very elongated nipple/areolar complex and her sense that her breast tissue ‘collapsed’ under her stretched areolas. This is similar to how a tuberous breast may present, except in this patient the breast under the nipple has virtually all atrophied after breast feeding.  This lead to collapse of the nipple/areolar complex. The patient could virtually push her nipple and invert it to her chest wall and sternum.  Almost like a hernia.

To correct her problem, she underwent a variant of the implant mastopexy.  During the surgery, a 350 cc silicone implants were placed under the muscle through the lower half of the areolar.  The underlying breast fascia is repaired and a limited areolarplasty or areolar reduction is completed.  This differs from a mastopexy as she did not have droopy breasts and did not need any cutaneous skin removed.  A second minor procedure was done in the office to reduce the nipple at a later date.  I do not like to perform nipple reductions at the time of implant surgery so we avoid risks to nipple perfusion, viability and we want to reduce potential bacterial contamination to the breast implant pocket which can cause capsule formation.  Any nipple reduction or treatment of elongated nipples can be completed as an office procedure painlessly with local anesthesia in about 30 minutes.

implantmastopexy and nipple reduction