How Can I Fix My Nipples?

Episode summary

Can nipple or areola shape be changed? Different procedures address excess nipple projection, inversion, areola size or a low position on the breast. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains why identifying the specific concern matters and why sensation and future breastfeeding should be part of the conversation.

Originally published August 20, 2020. Surgical techniques and anesthesia examples in the recording reflect Dr. Smith's practice at that time.

Key takeaways

🧬 Nipple and areola anatomy

The nipple is the projecting central structure; the areola is the surrounding pigmented skin. Their size, shape and position are separate features.

🩺 Nipple procedure options

Nipple reduction and inverted nipple correction address different concerns. Dr. Smith notes that inversion can recur and may require further treatment.

💬 Sensation and breastfeeding

Nipple procedures can affect sensation and breastfeeding ability. These tradeoffs deserve discussion before surgery.

📍 Areola and breast position

Areola reduction or reshaping concerns the pigmented skin, while a low nipple-areola position associated with breast drooping may require a breast lift.

🩺 Anesthesia planning

Some isolated procedures may use local anesthesia. A breast lift is a more extensive operation, and anesthesia planning depends on the procedure and patient.

Questions this episode answers

Can inverted nipple correction affect breastfeeding?

Yes. The recording specifically identifies possible effects on breastfeeding and nipple sensation as issues to discuss with the surgeon. The technique, anatomy and future feeding goals matter.

Is reducing the areola the same as lifting the breast?

No. Dr. Smith distinguishes making the areola smaller or more regular in shape from addressing a low position on the breast mound. He discusses breast lift surgery for the latter when breast drooping is the underlying concern.

Can men have nipple or areola procedures?

Yes. The episode notes that these concerns occur in men as well as women, although the appropriate plan depends on individual anatomy and goals.

ℹ️ Current health context

A new nipple or breast change should be medically assessed before assuming it is only cosmetic. Many breast changes are benign; the National Cancer Institute explains changes to discuss with a clinician. This context is separate from the cosmetic discussion in the recording.

🔗 Related information

Read about inverted nipple correction and breast lift surgery, or schedule a consultation.

Educational information, not individualized medical advice. Risks, recovery and results vary. Show notes updated September 30, 2026.

Original show notes

From inverted nipple correction, to areolar reduction, and so many other variants in between, this structure has increasingly found itself in the aesthetic limelight. Board certified NYC plastic surgeon Dr. Darren Smith explains.

[00:08] I'm Board Certified New York City Plastic Surgeon Dr. Darren Smith, and this is Plastic Surgery Before and After. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. How can I fix my nipples? This is a question we're asked frequently by people that are having other kinds of breast surgery, like a breast augmentation, a breast reduction, or a breast lift, and sometimes by folks who are purely concerned with the appearance of their nipples in isolation. The appearance of the nipples is a concern for both men and women, and it's actually something we deal with pretty frequently. Before we dive into nipple aesthetics and size and shape and position, the first thing that we should really do is establish some vocabulary. So the nipple is, simply put, the thing that sticks up in the middle of the breast on both men and women. The areola is the usually circular portion of the breast in both men and women that is pigmented more darkly than the surrounding skin.

[01:33] So together, the nipple and areola are called the nipple-areolar complex. And there are specific concerns that both men and women have with the size, shape, and position of both their nipple and their areola. So let's go structure by structure. The nipple itself is fairly straightforward, and this is something that someone may feel is either too big in the sense that it projects or sticks out too far from the breast or on the opposite end of the spectrum that it is inverted or that it actually recedes back into the breast rather than sticking out. So if a nipple projects too far from the breast, there are various kinds of nipple reduction procedures that we can perform. And a very popular option for this is we simply remove a ring of tissue around the outside of the nipple and collapse the nipple on itself, almost like we're...

[02:38] Folding a telescope back in on itself and we suture it together and that will very reliably reduce the degree to which the nipple projects for nipples that are inverted or that Stick back into the breast instead of projecting outwards. There are several ways that we can approach the correction of inverted nipples and this is generally a matter of making very small incisions or even just using pokes from a needle to break up the fibrous bands of connective tissue that are drawing the nipple back towards the chest wall into the breast. Often after these procedures, the nipple has to be suspended in its new averted position.

[03:29] either with sutures or even with a nipple piercing so that it can heal in the proper position and doesn't contract again back into the breast mound. The results of this procedure aren't quite as reliable as those that we can see from nipple reduction procedures and there is a certain amount of relapse that can occur and require secondary or revisional inverted nipple correction procedures. The other important thing to know about nipple inversion correction and also the correction of nipples that project too far out is that these procedures can interfere with both nipple sensation and the patient's ability to breastfeed. So these are specific things that we should discuss with your plastic surgeon before having either one of these procedures. So moving on from the nipple to the areola, we can discuss both the size and position of the areola as well as its shape. So essentially, The most common complaints about the areola are either that it is too large in relation to the rest of the breast or that it is too low in relation to the rest of the breast. In some instances, usually after another surgical procedure like a breast reduction or a breast lift, the areola can have an irregular shape and this is something that we also sometimes need to repair.

[05:01] Before we discuss the position of the areola, let's discuss issues having to do with its size. An areola can either just be large due to heredity or sometimes it can become enlarged after pregnancy and breastfeeding. In any event... This is a relatively straightforward issue to correct and the way that we do this is we will carefully design an excision of the outer rim of the areola to bring it to its desired shape and size and then suture the border of the new areola to the surrounding skin. In some instances usually in cases where we're performing a quite significant areola reduction, we may use permanent sutures to ensure that the areola remains steady in its new size and shape and spreading doesn't recur since there will by definition be some tension on the repair since we have removed the outer rim of the areola and the rest of the breast tissue is essentially tugging on it.

[06:16] Since in other breast procedures like a breast lift or a breast reduction, the areola is often moved on the breast mound. Its shape can become irregular and less round, and this is addressed in essentially the same way as an areola that is too large. we use a template to design a very round contour of the areola and then simply excise the portion of the areola that lies beyond this template and then we suture the remaining areola to the surrounding breast tissue and the template is actually called a cookie cutter because it is round and one side of it is sharp so that we can use it to mark the skin and it looks a lot like a cookie cutter. In terms of the position of the areola, this is something that we usually encounter in folks who are concerned about drooping of the breasts or what we call breast ptosis where it appears that the areola is too low on the breast mound and too low on the chest wall such that the breast has a deflated or saggy appearance.

[07:27] And this is something that we treat with a mastopexy or a breast lift. And there is an earlier episode you can listen to for details about how mastopexies and breast lifts are performed. So while it's more common for women to have concerns about the size and shape of their nipple and areola, this is something that we do see in men as well. And the procedures used to address these issues are very similar to those that are used in women. The nice thing about procedures to address the form of the nipple and areola and the nipple areolar complex is that they can almost always be performed with straight local anesthesia, meaning you don't need to go to sleep. You can be awake and breathing on your own, but we use local anesthesia to make sure the area is numb and you don't feel any discomfort. Of course, general anesthesia or twilight anesthesia remains an option, so you don't need to be awake, but the option is there if you'd like to have a more rapid, straightforward recovery. So this is something that you can literally come in, have done, and then just walk out of the office. The whole thing for many of these procedures takes under an hour.

[08:41] This is not the case for a breast lift or mastopaxi. This is a more invasive procedure that is performed under general anesthesia. And again, there's more information about breast lift and mastopaxi in an earlier episode. So issues with the nipple and areola are very common in women. We also see them in men and they usually are fairly straightforward to address. Thanks for listening, and don't forget to subscribe, share the show, and head over to DarrenSmithMD.com for more real-world plastic surgery talk.

Original Captivate episode. Original release date: 2020-08-20. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.

• inverted nipple correction
• breast lift surgery
• schedule a consultation
• Related episode: How Do I Choose My Breast Implants?
• Related episode: How Do I Choose a Breast Implant Shape?
• Dr. Smith’s background and training