There is a body complex that many women are hiding, but surprisingly, they are concerned about it a lot. That is, the shape of the nipples and areolas is not normal. The shape of the nipples and areolas doesn't have a serious impact on health, but it can put the person under stress and lower her confidence as a woman.

The most representative of nipple problem is ‘inverted nipples.’ Inverted nipples refer to the shape of the nipples that are rolled inward or retracted without the nipple protruding. Usually, it is caused by the weak development of mammary gland tissue or ducts at the stage of breast maturation, but it can also appear when breast tissue is changed due to mastitis or breast cancer. 

Inverted nipples cause various problems besides aesthetics. It is not hygienic because the nipples sweat well and the secretions are easily caught in the nipples, and this can lead to inflammation and papillitis. Also, the smell can make your sexual partner feel uncomfortable, which can lead to sexual trauma.

One of the biggest concerns for women with inverted nipples is breastfeeding. If the person has inverted nipples, it may be experienced difficulties while breastfeeding. 

Dr. Sang Mun Choi, a founder of Ryan Plastic Surgery Clinic, said, “If the mother has inverted nipples, the nipples do not adhere properly to the baby's mouth during breastfeeding, so even if the baby sucks, milk does not come out. The baby can gradually lose appetite because it does not produce breast milk no matter how much he sucks, and it can lead to an irregular life that does not get enough sleep, which can affect personality formation.”

Contrary to the inverted nipples, ‘Nipple hypertrophy’ which is the excessively large nipple can also be a problem. Nipple hypertrophy is congenital, but it can appear under the influence of hormones after pregnancy, childbirth, or breastfeeding. It often appears in men who have gynecomastia or have developed muscles around the nipples.

Many nerves are concentrated on the nipples, and if the nipples are too large, the nipples are easily stimulated, such as when wearing underwear or exercising, which can cause a lot of trouble in daily life, such as a tingling sensation or discharge.

The main concern about the areola is when the areola is large compared to the size of nipple. The areola grows during puberty as a normal growth process and grows again during breastfeeding. At this time, the areola sometimes abnormally enlarged. The size of the areola is not a functional problem, but once the areola is enlarged, it is difficult to return it to its original shape, and there are many cases where they want to improve it because it does not look good.

Abnormalities in the shape of the nipples and areolas do not pose a serious immediate threat, but appropriate improvement is necessary because they cause various inconveniences in daily life.

In the case of inverted nipples, adolescents who are experiencing secondary sexual characteristics are sometimes corrected naturally. While breastfeeding, nipples may come out spontaneously, but it is rare.

Nipple reconstruction is performed differently depending on the inverted nipple type. Inverted nipples can be divided into three stages according to the severity of symptoms. The first is a mild degree, when the nipple protrudes when pressed by hand, the second is when the nipple protrudes only when pressed with a strong force, and the third is severe, when the nipple does not come out even when pressed. 

Mild inverted nipples can be corrected by a non-incision method using a thread and can be improved by using an instrument such as inverted nipple corrector for a long time. The inverted nipples which protrude only when pressed with a strong force, can be corrected with a thread in some cases. If possible, doctors try to use a thread to correct it with a thread, but it is impossible due to the severe degree, it can be improved with surgery.

For severe inverted nipples, there are purse-string surgery and triangular flap surgery. The purse-string surgery is a method of making a small incision around the nipple, cutting the fibrous tissue that pulls the nipple inward, and pulling the nipple out by extending the duct and fixing it. The triangular flap surgery is a method of supplementing the sufficient dermal tissue by making an incision on both sides of the nipple to extend the fibrous tissue to remove the nipple, and then creating a triangular flap. If a strong structure is pulling from the inside, or if it is formed so that the tissue is sucked in from birth, surgery should be performed for reconstruction.

Nipple reduction is a surgery to reduce large nipples, so an incision is essential. Dr. Choi explained, “Just like when cutting a cake, cut off a part of the nipple and then suture the rest. If the length of the nipple is long, surgery to shorten the length is performed. Cut off the stem of the nipple and suture it up and down. If breastfeeding function is not necessary, the upper part of the nipple can be cut out to reduce the size of the nipple.

The important thing here is to be clear about the size of nipple. Once the nipple is reduced in size, it is difficult to make bigger again. The clear size decision can make a satisfactory result. According to Dr. Choi, reducing the size slightly larger than the desired size may be a way to prevent regret. 

Areola reduction, it is slightly different depending on the patient’s height, body size, and breast size, but it is appropriate to set the target areola size to about 3.8cm. Areola reduction is performed by excising unnecessary parts of the skin in a donut shape, and then sutures the remaining parts. At this time, if surgeon does not suture with a certain force, it may rebound. 

As nipple and areolas are sensitive areas, surgery should be decided carefully. During surgery, it is important to perform so that the nipple and areola are in harmony with the size of the breast. 

Dr. Choi advised, “The size of the nipples and areolas that are appropriate for the size of the breast is a factor that determines the overall beauty of the breast. Therefore, it is important to ensure that the shape and size of the nipples and areolas are in harmony with the size of the breasts. Above all, after nipple and areola surgery, it affects in your daily life. I think it is important to make more beautiful and healthy breasts by consulting with a doctor who has many experiences and knowledge about breast surgery before the surgery.”
 

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