Nippin’ Out

I just do not know how else to describe the recent article in Allure Magazine.   Quoting a London Daily Mail article about Victoria Beckham, they show a photo of her is a fitted top.   The photo prominently displays the shape of her nipples and areola.   The article claims surgical enhancement to create this appearance is becoming more popular.

The breast can be separated into three profile components.   First is the breast mound, which accounts  for the majority of  the breast size.   Traditional breast enlargement surgery enhances this through placement of an implant beneath the breast and/or muscle.   The center portion of the breast is highlighted by the nipple and areola.   This is the eye point or where a person looks when they look at another person’s (man or woman) chest.   The nipple is the central portion of this area.   It projects out from the breast normally.   The nipple represents the termination of the breast milk ducts allowing breast feeding.   The darker skin around the nipple is known as the areola.   Its color varies widely with genetic background and past pregnancy history.   The areola is usually flat in relation to the surrounding breast mound.   Sometimes this projects above the breast mound to add another contour to the breast.   This is apparent in the Allure photo.

There are a variety of cosmetic nipple surgeries.   The most common procedure in the past has been correction of inverted nipples.   In this condition, the normal milk ducts are too short and cause the central part of the nipple to be drawn inward thus reducing the nipple projection.   Correction of inverted nipples eliminates the ability to breast feed and can interfere with nipple sensation.   It is important  to understand nipple inversion can be a sign of breast cancer.   The internal mass can cause scarring of the milk ducts which draw in the nipple.   If a patient experiences this inward movement after having normally projecting nipples, they must be evaluated for a possible breast tumor.

Some women are self conscious of nipple prominence.   It embarrasses them when they wear clothing.   For those women I suggest the use of clear plastic adhesive dressings which flatten the nipples.   The dressings  are imperceptible beneath clothing.

Other women are requesting increased nipple and sometimes areola projection.   There are implants available but these  are generally reserved for  nipple reconstruction after breast cancer surgery.   In addition, there are many reconstructive nipple procedures which use the remaining skin and fat after the cancer surgery to make a new nipple.   The potential scarring resulting from these procedures require that they generally keep those surgeries in the realm of reconstruction surgery.

Women considering increased nipple and areola projection might consider temporary fillers like Restylane ® or Juvederm ®.   These will be reabsorbed after six to nine months.   If there are any reservations regarding the appearance, nothing need be done.   A more permanent solution is fat graft injections.   Fat taken from another area of the body is transferred with injections to the areola  and/or nipple.   The result  can be  permanent but some of the initial improvement will be lost as the body absorbs some of the transferred fat.

Just like clothing and hair styles, this fashionable trend may only be popular only for a season or two.   I think temporary solutions to increase nipple and areola projection are the best choices.  Any surgery is serious business and it should not be considered frivolously.



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