Nipple Reduction: An Adjunct to Breast Augmentation

  • Nabil Fanous
  • Amanda Fanous


Nipple hypertrophy is an unaesthetic breast feature commonly seen in the Asian female population. It can also be observed among Caucasian and Black women, but at a much lower prevalence. Few publications in the medical literature have addressed the proper management of nipple hypertrophy. Nowadays, the rapid and accelerating growth of the Asian communities across North America is an evident reality. Accordingly, tackling the occasional breast augmentation patient with an associated nipple hypertrophy acquires a special importance and certain urgency. Ideally, every plastic esthetic surgery practice needs to be prepared to handle it when encountered. The technique described herein is quite effective at correcting both the overprojection and the excessive width of the hypertrophic nipple. It is a simple nipple reduction approach that is easy to learn and as easy to execute. Importantly, in addition to its high safety profile, it preserves both the nipple innervation and its lactiferous duct network.

Whether used separately or as an adjunct to mammary augmentation or mastopexy, this novel approach delivers excellent esthetic results with a high patient satisfaction rate.



The authors express their thanks to “The Canadian Journal of Plastic Surgery” for granting the permission to use the figures of the original article; to Ildiko Horvath, medical artist, Montreal General Hospital, for her assistance in preparing the artwork; to Amina Flita, administrative assistant, for the typing and organizing of the manuscript; and to Minerva Khalife for her photographic contribution.


  1. 1.
    Lai YL, Wu WC. Nipple reduction with a modified circumcision technique. Br J Plast Surg. 1996;49:307–9.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Lai YL, Weng CJ, Samuel Noordhoft M. Areolar reduction with inner doughnut incision. Plast Reconstr Surg. 1998;101(6):1695–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Regnault P. Nipple hypertrophy. A physiologic reduction by circumcision. Clin Plast Surg. 1975;2:391–6.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Cheng MH, Smartt JM, Rodriguez ED, Ulusal BG. Nipple reduction using the modified top hat flap. Plast Reconstr Surg. 2006;118(7):1517–25.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Vecchione TR. The reduction of the hypertrophic nipple. Aesthet Plast Surg. 1979;3:343–5.CrossRefGoogle Scholar
  6. 6.
    Marshall KA, Wolfort FG, Cochran TC. Surgical correction of nipple hypertrophy in male gynecomastia: case report. Plast Reconstr Surg. 1977;60:277–9.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Sperli AE. Cosmetic reduction of the nipple with functional preservation. Br J Plast Surg. 1974;27:42–3.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Ferreira LM, Neto MS, Okamoto RH, Andrews J d M. Surgical correction of nipple hypertrophy. Plast Reconstr Surg. 1995;95:753–4.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Bostwick J III. Plastic and reconstructive breast surgery, vol. 1. St. Louis, MO: Quality Medical Publishing; 2000. p. 629–31.Google Scholar
  10. 10.
    Fanous N, Tawile C, Fanous A. Nipple reduction – an adjunct to augmentation mammaplasty. Can J Plast Surg. 2009;17(3):81–8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Nabil Fanous
    • 1
  • Amanda Fanous
    • 1
  1. 1.The Canadian Institute of Cosmetic SurgeryMontrealCanada

Personalised recommendations