Nipple Correction Sydney

Inverted Nipples Nipple or Areola Reduction Procedure Information Risks & Complications Procedure FAQs Procedure Pricing

Nipple correction surgery can be performed as a standalone procedure or in combination with other breast procedures such as breast augmentation, breast lift or reduction.

This surgery is for women who feel very self-conscious about the size, shape or position of their nipples. Dr Aggarwal at MODE will be happy to guide you through the consultation process and advise what surgery may be able to achieve what you are looking for.

Inverted Nipples

An inverted nipple is one that does not stick out from the breast.
Causes of this condition can include
- Congenital causes – this means it has always been present from birth
- Appeared later in life (acquired causes)
  - Breast cancer (always need to exclude this)
  - Scarring after breast feeding
  - Scarring after breast reduction or lift
  - Mastitis
  - Large breasts/enlargement of breasts

There are different severities of the condition

Grade 1 – nipple can be easily pulled out, and stays out without pulling on it. Pressure around the areola or by gently pinching the skin the nipple pops out.
- Here there is little or no scar tissue under the nipple
- Ducts of the breast are usually normal
Grade 2 – nipple can be pulled out but not as easily as grade 1. After releasing the pull, the nipple goes back in.
- Here there is moderate degree of scarring under the nipple
- Ducts of the breast are shortened or retracted – they may or may not need to be cut to improve the nipple retraction
Grade 3 – nipple is severely inverted and retracted. Very difficult to pull out the nipple manually.
- There is marked scarring under the nipple
- The ducts of the breast are severely scarred, shortened and retracted – usually need to be cut to improve the nipple retraction

Why women seek surgery?

Nipple inversion can be a cosmetic, and functional problem
Cosmetically women are troubled by the appearance of this condition and it can significantly affect women psychologically
Functionally it can be difficult or almost impossible to nurse an infant if the nipple is severely retracted
Women may have already tried some non-surgical ways of improving this condition such as nipple teats, piercings, breastfeeding or breast pumps.

Nipple or Areola Reduction

Large nipples/areola can be a source of embarrassment as they can show through clothes, and restrict what women wear.
In particular women who seek breast augmentation may find that implant insertion behind the breast is likely to make these nipples even more prominent.
This is therefore a procedure that aims to reduce the size of the nipple and/or areola and can be undertaken as a standalone procedure or in combination with other procedures (the most common being breast augmentation)

Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions in Canada and the USA. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at one of Sydney’s most prestigious public hospital campuses (POWH/SCH/RHW), and operates privately on Sydney’s North Shore. Dr Aggarwal has treated thousands of patients throughout Sydney and beyond who have achieved outstanding results under his care.

Procedure Snapshot

Anaesthetic: LA
Time: 30 minutes to 1 hour
Duration of stay: Day procedure
Results: Predictable and generally very good. Results can vary between patients.

Hospital: Can be done in rooms or in day surgery setting
Medicare/Health fund rebate: Yes for inverted nipple correction. Not for nipple or areola reduction.
Recovery: Most people can do most things straight away. Avoid swimming in a pool or beach for 2 weeks.

Procedure Information

The procedure is usually performed under local anaesthetic in rooms or in a day surgery setting

Mammogram and Ultrasound

Before any surgery on your breast Dr Aggarwal will refer you for a mammogram and ultrasound to ensure the breast is clear of any pathology.
This is particularly important in cases of nipple retraction that may have only recently appeared

Incisions

Nipple retraction correction

A combination of techniques that involve suturing, careful release of scar tissue under the nipple and modification of the nipple shape are used to correct nipple inversion
These can usually be performed under local anaesthetic or at most with some sedation and local anaesthesia
It is important to note that the ducts behind the nipple may have to be divided to achieve correction, which will mean you will not be able to breast feed in the future. However this is only required in the most severe cases of nipple retraction where without correction, it is not possible to breast feed any way.

Nipple Reduction Surgery

Can be performed under local anaesthetic or at most under sedation and local anaesthetic
It is a day surgery procedure only
Scars are localised to the nipple and involve a combination of removal and reorientation of tissue to bring about a reduction in the nipple size.

After your nipple corrective surgery

Dr Aggarwal will place waterproof dressings over the incisions. Under the waterproof dressings will be dressings placed around the nipple to prevent them being compressed with a bra.
You will be able to shower after 48 hours and can continue to wear a normal bra with some padding so your bra does not compress the area of the nipple surgery too much
You will not be allowed to swim in a pool or beach for at least 2 weeks after surgery.
You will be given a script for antibiotics by Dr Aggarwal which you must continue until the box runs out
You will also be given pain relief medications although most patients only report minor amounts of post-operative pain that is responsive to simple oral analgesia.
If you have had only local anaesthesia, you will be able to go home on your own, and you may drive home. If however you elect to have some sedation you will not be allowed to go back home on your own – you must have someone accompany you home, and you should not drive for at least 24 hours after surgery.
While most sedentary activities can be resumed in the first week, you must not do any exercise for the first few days after surgery that could raise your blood pressure.
Dr Aggarwal will see you a week after your procedure to inspect how the wound is healing. You will be given instructions how to look after the wound as it continues to heal. You will be able to ask questions about what you can and cannot do.

Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

General Complications

Bleeding (1-2%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. Usually this settles with compression.
Infection (<1%) – this is very rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.
Poor Wound Healing (2%) – This is usually rare around the nipple as the nipple and areola tend to heal very well. Slow healing usually resolves with dressings and simple wound care.

Specific Complications

Nipple compromise – this is a rare but most significant complication. When the nipple is reshaped or reduced the blood supply coming from the area just behind the nipple can be interrupted.
Change in nipple sensation or hypersensitivity
Loss of nipple erectile function
Reduced or loss of ability to lactate or breast feed: There is a high risk of this especially in correction of severe nipple inversion where the ducts to the nipple may need to be cut in order to achieve correction
Asymmetrical nipple shape or size – There can be a difference in how each breast behaves to surgery, and can produce an asymmetry to the scars, albeit the aim is to get them as symmetrical as possible.
Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.
Incomplete correction
Partial/complete relapse (3-10%).

Procedure FAQs

Do I need a referral for nipple corrective surgery?

It is advisable to obtain a referral for nipple correction as it is possible to claim a Medicare rebate of approximately $73 for the consultation if you have a referral
It is also possible that a Medicare/Health Fund rebate may apply to you if the procedure is for correction of nipple inversion, and having a referral allows you to claim this reducing out of pocket costs substantially.

Where can I see Dr Aggarwal?

You can see Dr Aggarwal at his main rooms in Gordon. Alternatively he also consults at Hornsby, Hunters Hill, and Camperdown. Scroll to the bottom of the page to find out more about these locations

Where will I have my operation?

The procedure may be offered to you in rooms or at any of the hospitals where Dr Aggarwal works – i.e. Sydney Adventist Hospital, SAN Day Surgery, Hunters Hill Private or Castlecrag Private hospitals

What can I do to prepare for surgery?

Cease fish oil, and other supplements such as Ginkgo, Ginseng.
Please discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.
If you are smoking you need to cease this well in advance of surgery as the risks of nipple compromise and poor wound healing significantly increase in smokers.

After surgery, will I need to wear a special surgical bra?

No but you should have some padding under the bra to prevent compression of the nipple area for a few weeks after surgery

Will I be able to exercise after surgery?

You should not do any exercise that raises your blood pressure for at least 72 hours after surgery to avoid the risk of an unexpected bleed

Will I need special medications after surgery?

Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief.

Will I need further surgery?

Not usually.
There are however small rates of relapse of nipple inversion after surgery which may require repeat surgery.

Can I travel in an airplane after surgery?

Yes
However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise.

When will I be able to swim after nipple corrective surgery?

You may swim in a pool or beach after 2 weeks as this is the time it takes for the incision to heal.

When will I be able to drive after nipple correction?

If you have had local anaesthesia only you may drive straight away
If you have had sedation in addition to local anaesthesia you can drive after 24 hours.

Do you offer local anaesthetic or sedation for nipple correction?

Yes this is how this procedure is performed routinely.

Will nipple correction change the sensation of my breasts?

Yes it can
Because surgery involves the nipple and tissues immediately behind the nipple the sensation of the nipple may reduce or it can sometimes become hypersensitive. It is also possible to lose erectile function of the nipple.
If this is of significance to you the only way to prevent it is to not have surgery at all.

Can I breastfeed after nipple corrective surgery?

There is a real risk of reduced or inability to breast feed especially after correction of nipple inversion.
It depends on how severe the nipple inversion is – mild or moderate cases usually do not require division of the underlying ducts, but in severe cases scar tissue and ducts behind the nipple have to be divided to achieve correction. This can mean a complete lack of the ability to breast feed. However in these severe cases where ducts have to be divided, the patient would not be able to nurse an infant anyway.

Can I have imaging for breast cancer screening after nipple corrective surgery?

Yes
However the additional scarring around the nipple can make breast mammogram and ultrasound more difficult to interpret by radiologists.
It is therefore important that prior to undergoing surgery you have imaging of the breast – it makes sure there is nothing of concern in the breast tissue, and also forms a baseline against which a post-surgery mammogram can be compared. A preoperative mammogram and ultrasound are essential to exclude breast cancer if you have recently developed nipple inversion.
It is important for you to participate in regular screening as you would have otherwise done for breast cancer based on your age and family history, after having surgery

Are there any alternatives to surgical correction of the nipple?

For nipple inversion there are a range of non-surgical options
These tend to work for mild cases only, with moderate or severe cases usually requiring surgery.
Options include
- Breast shells( milk cups, breast cups, or breast shields)
- Manually stretching out nipple 5x/day
- Breast pump/Nipple suction device
- Nipple stimulation.
- Nipple shield.
- Nipple piercing

Procedure Pricing

A quote for this procedure will be provided to you after a consultation with Dr. Aggarwal. You can also call or email our office for our current indicative pricing.
A Medicare item number usually applies to correction of nipple inversion, and if you have appropriate health insurance cover, the out of pocket cost may be reduced.
- We cannot take responsibility for health funds rejecting claims for coverage of surgeon/anaesthetist or hospital fees.
There is no rebate for nipple/areola reduction
Please note that the above price does not include
- Preoperative consultation fees

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