Dr. Ouakil, aesthetic surgeon in Paris, information, photos, prices, blog, reviews on nipple and areola surgery. This concerns a significant number of patients, estimated at 2% of the population.
A normal breast has an areola-nipple complex (PAM) which consists of a more or less dark disk (the areola) and an erectile nipple ("the tip of the breast") positioned in its center.
The size and position of the PAM can vary greatly. Beyond 5 cm in diameter, it is often perceived as too large.

The Nipple

The nipple has two main deformities that should be treated surgically:

1. hypertrophy: the nipple is too large, too prominent; it sometimes tends to point downward; its shape is not always circular.
2. invagination, or umbilication, which refers to a retracted nipple that is pulled inward, sometimes even inverted, which struggles to protrude, making it difficult or even impossible to evert, even after manual stimulation or during breastfeeding.
3. it is worth noting the occasional presence of supernumerary nipples, most often atrophic, located on the abdomen, either unilaterally or bilaterally, along a virtual vertical line passing through the normal main nipple. This condition is common and not serious. Excision followed by suturing may be considered for purely aesthetic reasons.

The Areola

Areola reduction is a more complex issue than it may initially appear.
Indeed, it generally needs to be associated with a breast lift, as the vertical clamp is essential to prevent excessive centrifugal tension, as seen in the round-block technique, and a secondary progressive expansion of the PAM that would lead to a loss of results. This results in an areola that is at least as large as before and an enlarged, unsightly scar around it.