Treatment of nipple hypertrophy by a simplified reduction technique

Background: Nipple hypertrophy is associated with physical and psychological sequelae, leading patients to seek corrective treatment. Objectives: The authors present a simple surgical technique to reduce nipple height with minimal tissue manipulation. Methods: Between November 2000 and October 2010, the senior author (CM) employed a nipple amputation technique to correct nipple hypertrophy in 30 consecutive patients. A horizontal incision was made through the distal portion of the nipple in the nonerect state to remove the predetermined nipple height. After nipple amputation, epinephrine-soaked gauze was applied to the surgical site for 5 minutes, followed by a postoperative dressing of nonstick gauze with antibacterial ointment. In 29 of the 30 patients, simultaneous breast procedures were also performed, primarily breast augmentation. Results: A total of 60 nipple reductions were performed on 29 women and 1 man (mean age, 37.8 ± 7.14 years). The mean follow-up was 35.9 weeks. All patients reported being satisfied with the procedure. Three patients noted decreased sensation, 1 noted a size discrepancy requiring further surgical intervention, and 1 noted persistent oozing from the surgical site on postoperative day 1. One patient who became pregnant postoperatively was identified; this patient was able to lactate in the postpartum period but was not able to produce enough milk bilaterally to perform breastfeeding. Conclusions: 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 in this case series.