Nipple Reduction Surgery Cost & Information Guide

What is a nipple reduction?

The nipples are the raised, projected sections of skin that are usually found in the middle of the breasts. The areolas are the dark, round circles of skin that are found around the nipples, as shown below.

A nipple reduction aims to reduce the size and the projection of the nipples or to restore symmetry. The procedure itself can take anywhere between 30 to 60 minutes to perform and can often be combined with a number of different breast procedures, such as:

• Areola reduction
• Female breast reduction
• Male breast reduction
• Breast uplift
• Breast enlargement

Some people may be unhappy with the size and symmetry of their areolas. An areola reduction is a surgical procedure that reduces the size of large or over-stretched areolas. If required, this can be combined with nipple reduction.

How much does nipple reduction surgery cost?

The price of nipple reduction surgery is typically around £2995. Prices can vary to reflect the specific requirements of each procedure.

During the consultation, every patient has the opportunity to outline what they are hoping to achieve from their procedure. In turn, the surgeon will make some suggestions to ensure the best possible results. These variants may include:

• Surgeon experience
• Anaesthetist experience
• Which hospital or clinic is chosen for the procedure
• The complexity of the individual procedure
• Surgical techniques
• The time required in surgery for each patient’s case

It is during the consultation that these tailored features are decided upon, and therefore it is only after the consultation that a final price can be determined. Once a final price is set, that price is inclusive and transparent. It will cover the following:

• Hospital costs
• Surgeon and anaesthetist costs
• Aftercare and follow-up appointments
• Overnight stays (if required)

Who is eligible for a nipple reduction?

The best nipple reduction candidates are patients who wish to reduce the size and projection or improve the symmetry of their nipples.

The ideal candidate should also be in good health before the surgery; this means following a healthy diet, stopping smoking and maintaining a healthy weight.

Finally, the best candidates for a nipple reduction will have realistic expectations about what the procedure can achieve. During the free consultation with a BAAPS/ BAPRAS surgeon, it is important to discuss whether certain goals can be achieved.

Male nipple reduction

Many men may be unhappy with the appearance of their nipples and describe having puffy nipples. Excess breast tissue, enlarged breast glands or changes in weight may cause the nipples to push outwards. The appearance of puffy nipples may cause men to feel self-conscious about their nipples and affect how comfortable they feel in certain items of clothing or when doing activities that require a bare chest, such as swimming.

Female nipple reduction

Many women experience problems with their nipples, such as having nipples that are irregular in shape or size. These irregularities may cause distress, discomfort or chafing when wearing certain clothing. Nipple size and shape can be affected by things such as weight loss or gain and changes to the breast after pregnancy or breastfeeding.

What will a nipple reduction not resolve?

A nipple reduction procedure will solely address problems with the size and shape of the nipple itself. This is the raised, central part of the breast. A nipple reduction will not change the appearance of the areola, which is the darker circular area around the nipple. If patients have concerns regarding the size or shape of your areola, they may wish to have an areola reduction procedure.

Depending on concerns, patients may wish to have an areola reduction instead of, or in combination with, a nipple reduction procedure. If necessary, the two procedures can be performed at the same time. Patients should discuss with the surgeon exactly what they wish to change in the appearance of the chest so that the surgeon can advise patients as to what procedure is right for them.

How is a nipple reduction procedure performed?

The technique that the surgeon will use to reduce large or puffy nipples will depend on whether patients are only having a nipple reduction procedure or if patients are having the procedure in combination with another procedure, such as an areola reduction or another type of breast surgery.

Below is an overview of what the nipple reduction procedure will involve from start to finish.

Consent

Before undergoing nipple reduction surgery, patients will need to give consent for the procedure. Patients will do this by signing a consent form on the day of or before the surgery. Once the patient is happy to go ahead with the procedure, the surgeon may draw incision lines with a surgical marker on the chest area to demonstrate where they will be making the surgical incision.

Anaesthesia

For a simple procedure such as a nipple reduction, patients will usually have a local anaesthetic. This will numb the area so that patients do not feel any pain or discomfort during the procedure. However, sometimes sedation or general anaesthetic may be required. This is more likely if the nipple reduction is carried out at the same time as another procedure. If this is required, you will see an anaesthetist prior to the procedure. The anaesthetist is the doctor who will be administering the anaesthetic drug. The anaesthetist may give patients a sedative drug at the same time as the administration of local anaesthetic to help them feel relaxed. Sometimes general anaesthetic will be used if this was discussed prior to the operation. This will put the patient to sleep throughout the entire operation, but bear in mind this type of anaesthetic generally carries more risks.

Surgery

The patient will move to the operating theatre, where the surgeon will prepare them for the operation. They will begin by cleaning the treatment area and draping over a sterile sheet.

There are various techniques that may be used for nipple reduction; the exact technique the surgeon will use will be discussed in consultation beforehand.

To reduce the height and width of the nipple, a common technique involves an incision made into the protruding nipple to the base. On the side of the nipple, a small section of tissue is removed and pulled down, forming a smaller width and lower nipple height.

The surgeon will use stitches to secure the nipple into its new height and close the incision. The surgeon may use absorbable and/or non-absorbable sutures. They will then apply a light dressing to help protect the treated area.

Return to the ward

Once the surgeon has completed the procedure, patients will move to a recovery room. Over the next few hours, the anaesthetic will gradually wear off. The nurses on the ward will ensure the patient is comfortable and at ease.

What to expect from a nipple reduction consultation?

If patients are considering a nipple reduction and think this is the right procedure, the first step is to have an initial consultation. This is the time for patients to meet with a surgeon to talk through what the operation involves. This will take approximately 15- 30 minutes.

During the consultation, patients should discuss with the surgeon what they want to change about their nipples or breasts. Patients should be as clear and open as possible about their concerns and expectations so that the surgeon understands exactly what it is the patient wants to achieve. The surgeon will then carry out an examination of the nipples, areolas and breasts. They will consider the patient’s goals and advice whether this procedure will give the results you are after. Alternatively, they may suggest a different procedure if they feel that it is more appropriate and can give you the desired goal.

The surgeon will also talk through the risks and complications of the surgery. They will need to ask the patient some questions to assess suitability for surgery. For example, they may ask:

• Any past surgeries?
• Any medical conditions?
• Any medications, including over-the-counter and herbal remedies in use?
• Alcohol/cigarette/recreational drug use
• Any allergies?

It is important that patients answer these questions honestly and give the surgeon as much information as possible.

Questions to ask during the nipple reduction consultation

The nipple reduction consultation will also be an opportunity for patients to ask the surgeon about anything they are uncertain of. Patients might find it helpful to write down some questions before the consultation to bring with them. Some things you might want to ask may include:

• Is a nipple reduction appropriate for what I wish to change?
• Do you have any before and after pictures of previous nipple reduction surgeries?
• Where will the scars be, and how small/big will they look?
• How long is the recovery period?
• How much time do I need to take off work after the surgery?
• Will my nipples be sore after surgery?
• How soon until I can see the final results?

The surgeon will answer the questions to the best of their ability. Most surgeons strongly recommend a two-week “cooling off period” between the consultation and having a procedure. This is to ensure that patients have had time to think everything through and know that this is the right choice for them at this time.

What are the main nipple reduction risks and complications?

Some general risks and complications that can occur in any surgical procedure include:

• Post-operative nausea and vomiting
• Development of a blood clot in the leg or lungs
• An allergic reaction to the anaesthetic
• Post-operative pain

Bruising and bleeding

Most people will experience some bruising or bleeding after surgery. Bruising around the treatment area is common and can take up to two weeks to fade completely. It is also normal to see some minor bleeding in the dressing right after the surgery. If, however, the wound bleeds more than normal, patients may be required to stay in the hospital until this settles. Patients should let the surgeon know if they notice any blood coming from their wounds.

Infection

There is a risk of wound infection after surgery. However, the risk of this in nipple reduction surgery is quite small. If it does occur, the majority will resolve with antibiotic treatment. Rarely, if the infection has spread further, patients may require a further operation. The signs of infection patients should be aware of are the following:

• Temperature over 38° C.
• Redness at the incision line that is spreading away from the incision after 48 hours.
• Yellow pus-like or foul-smelling fluid seeping from the incision.
• Increased pain or discomfort of the treated area that pain medication does not resolve.

Let the surgeon know immediately if any of these signs show so that the infection can be treated promptly.

Scarring

Scarring is to be expected with any surgical procedure. The scaring on the nipple is usually well hidden and blends well. Patients can discuss with the surgeon the size and location of the scar they can expect. Scarring will fade over time.

Numbness or loss of sensation

It is possible that patients may notice a change in the sensation of the nipples. This can include numbness, tingling, or pain in or around the nipple. Some patients report the nipples feeling more sensitive after surgery. Usually, this change in sensation is only temporary and will eventually settle. However, on rare occasions, it is possible for the permanent loss of nipple sensation to occur.

Inability to breastfeed

A nipple reduction procedure may affect the ability to breastfeed. During the procedure, persevering the milk ducts cannot be guaranteed, but it is something that is taken with great care. Some patients may not be able to produce as much milk as before the surgery. . Talk to the surgeon if patients have plans to breastfeed in the future. The surgeon may advise patients to complete their family before undergoing a nipple reduction if they desire to breastfeed. It is important to note that some patients are not successful in breastfeeding even though they have not had any breast surgery.

Aesthetic issues

There is always a possibility that patients are unhappy with the results of the surgery. This may be due to asymmetry or scarring. This is not always caused by a surgeon’s lack of skill or expertise. Some irregularities in scarring or discolouration may occur according to the patient’s skin type and genetics. Furthermore, if patients become pregnant or their weight changes dramatically, this can change the shape of the nipple. Patients can minimise the chances of being unhappy with the final results by clearly discussing any aesthetic goals with the surgeon.

How to prepare for a nipple reduction?

Although nipple reduction is a relatively simple and short procedure, it is still important to be prepared for the surgery. Remember, even small changes in your lifestyle can make a dramatic difference in the way patients heal and recover from an operation. Make sure that in the weeks before surgery, to stop smoking, maintain a healthy diet and get some exercise when possible. Here are some tips on how to prepare for surgery:

Household work

To make life easier when returning home after surgery, it’s a good idea to either complete some household tasks beforehand or allocate these to another household member. For example, patients may wish to give the house a clean. It is also a good idea to take the rubbish out so patients can avoid having to lift heavy, full bin bags right after the operation.

Shopping

It's recommended that patients do a big food shop a day or two before the operation and stock up on groceries that they will need for the week after surgery. This will mean that patients do not need to make a trip to the supermarket in the early days after the surgery, when they may not feel up to leaving the house.

Young children and pets

If patients have children or pets, they may wish to ask a friend, relative or babysitter to look after them during the recovery period. After surgery, patients may lack their usual energy, so doing this will take some pressure off. This will also allow patients to relax so that they can rest and recover properly fully.

Driving

The effects of a general anaesthetic may leave patients feeling tired and groggy in the hours after the surgery. Therefore for patient safety, they will not be allowed to drive for 24 hours. Arranging for a friend or family member to pick them up at the hospital after the surgery so that they can drive home is a good idea. Depending on how patients feel, they may wish to have them stay over for at least the first night. This is especially important if there is no one else at home. Having a familiar face after an operation will make patients feel more at ease.

Diet

A healthy diet is a very important part of preparing for any type of surgery. Eating a balanced diet in the weeks before will allow the body to be in a better state for a surgical procedure. Eat lots of nutritious fruit and vegetables, as well as foods high in protein such as chicken, fish or tofu. Keep the intake of caffeine and sugary or salty foods to a minimum, and stay hydrated by drinking plenty of water.

Clothing

After the nipple reduction procedure, it is best to wear loose items of clothing. This is so that the clothing does not rub against the treatment area, which may at first feel slightly sore. Therefore, before the day of the surgery, be sure that there is enough appropriate clothing ready for the recovery period.

Sleeping

In the week leading up to surgery, try and make time to get enough sleep every night. Sufficient rest is crucial for allowing the body to prepare for a surgical procedure. Also, make sure that there are enough pillows prepared for after the surgery. Resting on these in an elevated position can help to reduce any swelling around the treated area.

Whilst these nipple reduction preparation tips should help you feel more ready for surgery, patients should always follow their surgeon’s specific preparation instructions.

Review your pre-operative instructions

Before the operation, clear instructions, including which medication you must stop and fasting instructions, will be given to you. It is vital to follow them.

Confirm your transportation and after-care plans.

It is essential you have someone to both take you home and stay with you for the first 24 hours after surgery.

Pack your bag

Consider bringing comfortable, loose-fitting clothing, toiletries, paperwork and anything you feel you need after your surgery. Try to limit bringing valuables. Wear comfortable clothing and do not wear jewellery. Each location has its own guidance, but typically patients will not be able to wear make-up, acrylic nails, contact lenses or body piercings.

What to expect after a nipple reduction?

There are certain aspects of nipple reduction aftercare that patients will need to follow to ensure that the surgical area heals well. This includes taking time off work, avoiding strenuous exercise, and washing and caring for the wounds properly. Below, there are some general hints and tips; however, the surgeon will give specific advice and further information that patients should follow.

Waking up after surgery

After the surgery, wounds will be covered with dressings. These will stay in place for a couple of days before being removed. The treatment area may, at first, feel slightly tender and sore. Patients might also notice some minor swelling or bruising around the area. The surgeon may suggest that patients take painkillers to ease any discomfort and reduce any swelling. As a nipple reduction is a minor procedure, patients will usually be able to return home on the same day. However, if they were put to sleep with a general anaesthetic, they may be required to stay a night in the hospital. Patients may also feel tired and groggy from this anaesthetic.

The first 24 hours

It is good to have another adult stay with the patient for at least 24 hours after the surgery. Particularly if they have had a general anaesthetic, patients may feel tired or dizzy, so it is best to have someone around. Having a friend or relative stay with the patients whilst they recover will also mean that they can help with specific tasks like cooking or cleaning.

Time off work

The length of time patients should take off work after the surgery will depend on the type of job the patient has. If the work is active and requires patients to be on their feet, it is advised that they take at least one week off. However, it may only be necessary to take a few days off if they have an office job. The surgeon will give a specific time frame that patients should follow.

Exercise and sport

Immediately after the surgery, it is essential that patients fully rest to allow their bodies to heal. Strenuous physical activity, particularly in the first week, can increase swelling and affect recovery. Patients can gradually start resuming physical activities after a couple of weeks. Start off with some light walking, then gradually resume sports that do not require vigorous movements, like cycling. After four to six weeks, patients should be fine to get back to their usual fitness regime.

Swelling & bruising

Some swelling around the nipple may occur after the nipple reduction surgery. Patients may also notice some mild bruising around the area. This is common and should generally begin to settle after three to five days. For the first few weeks, avoid activities that may increase swelling, such as vigorous exercise, lifting heavy objects, or using saunas and hot tubs. Try not to touch the treated area too much, and sleep on your back rather than your front to avoid compressing the nipples.

Scarring

Patients will have scarring as described above following a nipple reduction surgery. For the first few weeks, any scars may appear raised. Over time they will fade to faint lines that will be discreet. Taking care of the scars by moisturising and protecting them from sun exposure can help with the healing process.

The final results

Patients will most likely see a noticeable difference in their nipples immediately after the surgery. However, it is important to be patient as it can take up to six months for the scar to mature to appreciate the full cosmetic results. After the operation, the surgeon will cover the treated area with a protective bandage or dressing to support the nipple. The surgeon will tell patients how long this needs to be kept on.

Listening and adhering to the surgeon’s post-operative advice is essential in order for patients to achieve the best results from the surgery. A follow-up appointment within a couple of weeks will be organised as part of the nipple reduction aftercare. The surgeon will check the wounds to ensure they are healing well and will remove any stitches if necessary.

Currently, there are no options other than surgery that can reduce the size of the nipple. Your surgeon can discuss with you the best surgical technique and procedure for you that will achieve the results you desire.

It may be possible to breastfeed after a nipple and areola reduction. However, this depends on a number of factors including what surgical technique the surgeon uses. Therefore, it is usually advised that you postpone this surgery if you have plans to breastfeed in the future. It is best to discuss with your surgeon about how this procedure might affect your ability to breastfeed, and what the most appropriate option is for you.

If you have recently had a baby and are currently breastfeeding, your surgeon may require you to wait for 3 to 6 months before you have a nipple reduction. This is so that your breasts and nipples can settle before the procedure.

All of the information found on our website is sourced from highly reputable experts, government-approved authorities and is widely used by healthcare professionals.

• https://www.nhs.uk/conditions/cosmetic-procedures/breast-reduction-female/ NHS
• https://baaps.org.uk/patients/procedures/5/breast_uplift_mastopexy British Association of Aesthetic, Plastic Surgeons
• https://www.plasticsurgery.org/reconstructive-procedures/breast-reduction/procedure American Society of Plastic Surgeons