Nipple and Areolae Reduction in Dallas, Texas

Part of any cosmetic breast surgery should include evaluation and correction of the nipple/areolar complex. Too often this central part of the breast is ignored, and the aesthetic result is compromised as a result.

When undergoing any cosmetic procedure such as breast augmentation, breast lift, or breast reduction surgery, your plastic surgeon should evaluate the size, shape, and proportion of your nipple-areolar complex to your goals for breast size in your breast enhancement procedure.

Dr. John Burns, Jr., MD routinely performs both nipple and areola reduction in combination with breast enhancement procedures such as breast augmentation, breast lift, and breast reduction surgery.

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Nipple and Areola Reduction in Dallas, Texas- Dr. John Burns MD

Are Nipples & Areolas The Same Thing?

No, actually. The nipple is the central part of the areola that protrudes from the breast tissue. As a result of either development or breastfeeding, nipples can sometimes be over or under-projected.

The areola is the circular pigmented tissue that surrounds the nipple. The areola sits flush with the breast skin in most cases.

Why Do Women Resize Their Nipples And Areola?

Reasons Women Get It Done

Throughout various stages of life, many women navigate feelings of self-consciousness related to the size and appearance of their areolas and nipples. During puberty, rapid breast development can result in changes that some individuals may perceive as disproportionate or aesthetically different from societal ideals.

Similarly, post-pregnancy and breastfeeding can introduce transformations in breast shape and size, leading to alterations in areolar and nipple appearance that may not revert entirely post-partum. As women age, natural changes in breast tissue, skin elasticity, and overall body composition can further impact the size and shape of the areolas and nipples. These cumulative experiences, marked by significant life events and physiological changes, can contribute to feelings of insecurity or dissatisfaction with one's breast aesthetics, prompting the need for procedures like nipple and areola reduction.

Elongated Nipples

Studies show that the average nipple length is about 0.9cm. While some prefer longer nipples, many do not. Long nipples can be sensitive, difficult to hide in clothing, and can even fold over in abnormal ways. Correcting an over-projected nipple involves removing the excess length and placing a few dissolvable sutures in the end. This is easily accomplished as a part of any cosmetic breast procedure.

Inverted Nipples

About 3% of the female population has inverted nipples. This occurs when the central part of the nipple is abnormally attached to the breast pulling the nipple inward so that it does not project. The deformity can even have a “pin-cushion” appearance. Correcting an inverted nipple is a bit complicated and involves cutting the abnormal attachment below the nipple. Patients should understand that cutting these attachments can impact breastfeeding in the future.

Underdeveloped Nipples

In some cases, the nipple is underdeveloped without being inverted. For women who desire more nipple projection, correction usually involves a local flap of tissue or filler to plump out and raise the nipple tissue.

Enlarged Areolas

The areola should be approximatelyt ⅓ the distance of the base diameter of the breast. The base of the nipple should be about ⅓ the distance of the areola. If the areola is larger than ⅓, reducing the size might be cosmetically recommended. This is done by excising a rim of areolar tissue leaving the correct measurement remaining. This procedure is commonly known as a “donut mastopexy” or peri-areolar mastopexy. Many times the areolae are asymmetric and one will need to be reduced more than the other.

Small Areolas

Some women naturally have very small areolae. This is considered attractive by many women but some do prefer more normal dimensions. If having a small areola is a concern, a cosmetic tattoo can enlarge the pigmented skin. Modern breast areola tattoos are done in 3D, producing a much more natural appearance than older methods for nipple tattoos

Before and After Areola Reduction In Dallas, Texas- Dr. John Burns

Before and after Areolar Reduction in Dallas, Texas by Dr. John Burns MD
Before and after Areolar Reduction in Dallas, Texas by Dr. John Burns MD
Before and After Areola Reduction in Dallas, Texas- Dr. John Bur

How Enlarged Areola & Elongated Nipples Disrupt
Breast Harmony and Aesthetics

Because the nipple-areolar complex is the central point of the breast, it often garners the most attention on a woman's chest. "The Rule of Thirds" applies where the areola is about ⅓ the distance across the breast (base diameter) and the circumference of the nipple is about ⅓ that of the areola. Nipple projection averages about 0.9cm. Achieving anatomic proportions is paramount to achieving the optimal cosmetic outcome.

How To Tell If I'm A Candidate For Nipple Reduction Surgery?

Again, "The Rule of Thirds" is a great place to start. Patient preferences do matter and some may be bothered by dimensions that don’t fit this rule. If anything about your nipples or areolae bothers you, it's recommended to discuss options with your board-certified plastic surgeon.

Techniques Performed by Dr. John Burns, MD


This is done by removing the end of the nipple so that the remainder is the right size for the patient. The end is loosely sewn together to taper the end and re-create normal anatomy.

Inverted Nipple Correction

This is done by dividing the abnormal attachments and pulling the center of the nipple downward. A small incision is made and either a blade or scissors are used to divide the abnormal attachments. This can result in an inability to breastfeed.

Nipple elongation for patients with underdeveloped nipples. Usually, a local flap or fillers are used to elongate the nipple.

Areola Reduction

This very common procedure is done using a “donut” pattern where excess outer areolar tissue is removed leaving the appropriate-sized areola behind. When this is sewn together there can be some pleating of the incision because there is more skin on the outer rim. This will generally settle as the incision heals leaving a smooth white scar around the new areola.

Areola Enlargening

A medical tattoo is used to create a 3D appearance of an appropriate-sized areola for a patient who requires better areolae aesthetic when compared to the overall breast.

These procedures can be done under local anesthesia although for most cases a more sterile operating room environment and sedation are usually necessary for most patients. Additionally, these procedures are commonly done in combination with other procedures like breast augmentation, breast lift, or breast reduction. In breast lift or reduction surgery, the areola is automatically cut and sized as part of that particular procedure.

How Is A Nipple/Areola Reduction Done?

Nipple Reduction

A nipple reduction is done by removing the end of the elongated nipple loose sutures are placed to taper the end and restore normal anatomy.

Areola Reduction

The areola are reduced using a “donut” pattern where the outer part of the areola is removed leaving the appropriate size areola behind. There can be some pleating of the incision as there is more skin on the outer part of the donut pattern. This usually flattens out as the incision heals leaving behind a fine white line.

Combining Procedures with Areola Reduction

These procedures are commonly performed with other cosmetic enhancements such as breast augmentation, breast lift, a breast reduction procedure, or a mommy makeover. In cases where women desire a breast lift or breast reduction, the areola is typically resized as part of the procedure.

Do I Need A Breast Reduction Or A Breast Lift?



If done as a standalone procedure, a nipple and/or areola procedure requires very little recovery time. If done as part of another cosmetic procedure such as a breast augmentation, breast lift, or breast reduction then the recovery would depend on that procedure. A breast augmentation requires a day or two to recover while a breast lift or reduction requires a slightly longer recovery.

Most patients can drive is less than a week and return for light exercise in several weeks. Post-surgery care generally includes local incision care with antibiotic ointment followed by scar care which generally includes scar cream, silicone sheeting, and possible laser treatment for the incision. Laser treatments are done in our skincare and laser center, EpiCentre.

Patients will need to wear a post-surgery bra for support during the healing process. The bra is worn night and day for the first 3 months. Underwire bras are generally avoided until the incisions are healed at about 6 - 8 weeks.

Final Results

As with any procedure, the incisions take about 6 months to fully heal and mature. Early results are immediately visible and bruising and swelling take a couple of weeks to resolve.

Ask A Question

Frequently Asked Questions

Is the surgery safe?

Yes. Cosmetic nipple and areolar reduction surgery is extremely safe.

How much is a nipple/areola reduction surgery in Dallas?

A nipple reduction is typically around $1,500. An areola reduction is also called a donut mastopexy or peri-areolar mastopexy is about $5500 which does includes surgeon's fee, facility fee and general anesthesia.

Will an areola reduction fix my puffy areolas?

Generally, yes. The areola reduction creates a tighter skin envelope which helps to flatten the areola.

Will I lose sensation in my nipples after surgery?

No, sensation to the nipple comes from the rib cage and travels up into the breast from the deeper tissue. Because these procedures are superficial they usually do not cause loss of nipple sensation.

Can you breastfeed after nipple and areola reduction?

The change of breastfeeding after nipple or areola reduction is generally very good. However, with the correction of the inverted nipple deformity breastfeeding can be negatively affected.

Will my scars be visible after nipple/areolar reduction?

Healing incisions are red and raised. After about 6 months they should take on a thin white appearance which blends into the normal breast skin making them difficult to detect.

Schedule Your Consult with Dallas Plastic Surgeon,
Dr. John Burns, MD, FACS

Schedule your private consultation with Dr. John Burns.  Dr. Burns offers both virtual and in-office plastic surgery consultations for men and women seeking cosmetic rejuvenation in Dallas, throughout the United States, and the world.

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