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Nipple Scars
Nipple scars are usually the result of
periareolar
incisions commonly used during many breast augmentation, mastopexy and breast reduction procedures. Although typically associated with the
nipple,
the scar actually lies on the border between the
areola
and the ordinary breast skin. The periareolar approach is a very popular method of gaining entrance to the interior of the breast and is utilized by more
cosmetic surgeons
than perhaps any other incision type.

Nipple Scars from Breast Enlargement
Periareolar breast enlargement
is the most popular approach used world wide for placing prosthetic breast implants.
Saline breast implants
are inserted empty and only require a small incision which rarely leaves any noticeable evidence.
Silicone breast implants
must be inserted fully filled and require a much larger incision which is more likely to leave a noticeable scar on the nipple/areola. Women with small areolae do not make the best candidates for this surgical approach, since a
breast scar
which extends farther than the natural areola border will be much more visible. Particularly heavy implants might stretch out the areolar incision during the healing process making the scar far more obvious and possibly necessitating a
scar reduction
procedure.
Nipple Scars from Mastopexy
Breast lift
procedures always utilize some form of areola incision. In less invasive techniques, such as the
crescent lift,
the incision might only outline the upper border of the areola. In moderate lifts, such as the
donut mastopexy,
the incision will be made around the entire nipple/areola complex. More invasive lifts will require a full circle nipple incision with additional vertical and possibly horizontal incisions in the actual breast mound. Incisions which are performed with care should heal to a fine line which will not draw attention unless actively searched out.
Large breasts
might immediately stretch the scar after the lift procedure, making it more noticeable.
Nipple Scars from Reduction Mammoplasty
Breast reduction
will always use a variety of incisions, including a full circle nipple incision. Reduction procedures are the most invasive and scarring of all
cosmetic breast surgeries.
Scars around the areola will most likely be noticeable, as will other scars on the breast. A truly talented surgeon can minimize these scars to a simple thin line, but it is rare that scarring will disappear completely. One benefit of
reduction mammoplasty
is that the weight and heft of the breast is considerably lightened by the procedure, lessening the chance of stretching the fresh incisions.
Recommendation on Nipple Scars
A properly placed periareolar incision will heal to form a barely noticeable line on the natural border of the areola. Many
plastic surgeons
take pride in their ability to create scars which seem virtually invisible to the naked eye. I have personally seen all variety of scars from periareolar approaches of all sorts. Their range is as diverse as the women who are affected by them. I have seen periareolar plastic surgery scars which were utterly invisible, even under close observation. I have also seen large raised scars which unfortunately diminished the surgical results for many women. Remember, that there are always scar reduction techniques which can be very effective in reducing or even eliminating scars anywhere on the body, including the nipple. Ask your doctor about how to prevent scars prior to surgery and how to get rid of them in the event they are problematic post-operatively.
Nipple Scars to Breast Surgery
1/29/08 Revised 6/12/11
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