Plastic Surgery
Dr. Barry Eppley

Explore the worlds of cosmetic
and plastic surgery with Indianapolis
Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

Posts Tagged ‘nipple reduction in men’

Nipple Reduction Surgery in Men and Women

Sunday, December 15th, 2013


The size of the nipple on a man’s or woman’s chest is often unnoticed, until it becomes too long. A long nipple, known as nipple hypertrophy, can be both a source of embarrassment and irritation. It can be challenging to hide under light clothing and leads to chronic irritation and chafing from rubbing against clothing. For these reasons, both men and women seek nipple reduction surgery.

Nipple hypertrophy (macrothelia) is more frequently seen in Asians and less common in Caucasians. Why a nipple grows long is not known. There is some familial association to it and it can appear after adolescence or following pregnancy. It is almost always bilateral although one-sides long nipples do also occur. Once it develops, the long nipple persists throughout life and does not recede.

The nipple has a specific set of desired shapes and sizes. The ideal nipple has a cylinder shape with a “dome-like” top with projection between 6-10mm in women and between 3 and 6mms in men. . The nipple in women can be aesthetically tolerated to be longer in women than in men. and is often naturally so for the obvious reason for or as a result of breastfeeding. However, in cases of nipple hypertrophy lengths can be up to 2 cms in women and 1 cm in men.

Nipple reduction surgery is relatively simple given the small surface area of its projection. When planning for a nipple reduction surgery two factors are important to take into account for women, nipple sensation and preservation of lactation. For men, none of these functional issues apply. Procedures available include the classic wedge amputation technique which involves excision of the nipple core that cuts through the lactiferous ducts and disrupts lactation as well as reducing nipple sensation. There is also the sleeve resection method where a strip of tissue is removed from the base of the nipple without cutting across its core. This nipple reduction method preserves nipple sensation and theoretically preserves lactation as it does not disrupt lactiferous ducts.

Male Nipple Reduction Surgery Results Dr Barry Eppley IndianapolisMale nipple reduction always uses the wedge reduction technique as men want as flat as nipple as possible. It is not important to them whether any residual nipple projection is left nor is preservation of sensation an issue. While the wedge reduction technique is simple, one has to be careful to not take too large of a wedge as an inversion deformity can result. Loss of the color difference between the nipple and the areola will occur although this is not an aesthetic concern. It can be comfortably done as an office procedure under local anesthesia.

Female Nipple Reduction Dr Barry Eppley IndianapolisFemale nipple reduction can use either the wedge or sleeve reduction methods. The choice often depends on how much excessive nipple length exists, whether it is bilateral or on just one side and if no further pregnancies are planned. Wedge nipple reductions in women are easier than in men because some residual nipple length is maintained. Sleeve reduction methods are more technically precarious as maintaining a central core of tissue is essential for nipple survival. Nipple reduction can be safely combined with breast augmentation or breast lifts.

In summary, nipple reduction is very effective and the scars are hidden in the nipple-areola junction. It has  no real recovery and can be safely combined with an other forms of breast or chest enhancement surgery.

Dr. Barry Eppley

Dr. Chris Ueno

Case Study: Reduction of the Prominent Nipples in Men

Saturday, August 28th, 2010

Background:  The nipple, technically known as the nipple-areolar complex, is present in both men and women. While it has a functional role in women, it is a non-functional vestigial structur in men. While a man’s chest would look strange without it, it aesthetically should blend in and be relatively non-prominent. Changes in the size and shape of the nipple are undesireable.

One of the undesireable topographies of the nipple is when the nipple is too long or enlarged.  Rather than having a fairly smooth chest contour across the nipple’s surface, a prominent nipple creates an obvious two-tiered structure. This not only sticks out and is obvious when one is bare-chested but protrudes through shirts. ‘High beams’ in men is particularly bothersome to most men and is a source of embarrassment. Concerns about a prominent nipple can affect what type of clothes to wear.

Case: This is a 24 year-old male who was concerned about his prominent nipples. He said they were not always so and had appeared just a few years ago. They stuck out all the time and he was not comfortable wearing any type of form fitting shirt. Exposure to cold made them stick out even further.

In discussion about their reduction, he was not concerned about whether any feeling remained in them. He was most concerned that they were as flat as possible and did not have any noticeable scarring. Two techniques for nipple reduction were reviewed, wedge excision and circular or donut reduction. Wedge excision nipple reduction is essentially an amputation method where it is completely removed. It will make the nipple completely flat (because it is gone) but there will be no tiny mound or slight raised area where the nipple would normally be. The invisible scar will have the same tissue characteristics and scar as the surrounding areola. The circular method removes a ring of nipple tissue at its base and shortens it. This will not make it flat and will leave a smaller raised nipple mound. Feeling in the nipple may be maintained after.

Under local anesthesia in the office, the nipples were removed by wedge excision that were vertically oriented. The excised area was closed with small dissolveable sutures. The only dressings applied were glued on tapes that only covered the diameter of the areolas. The entire procedure was completed in 30 minutes.

The results are immediate without swelling or bruising. There are no restrictions from any activity after surgery. One can shower, swim and workout the very next day. The results will be permanent as the nipple can never grow back.

For those men, young or old, that are bothered by a long or prominent nipple can quickly solve this problem without pain, recovery, or prominent scarring.

Case Highlights:

1)      Nipple protrusion in the male is a source of embarrassment and usually develops after puberty in most cases.


2)      The wedge excision (amputation) technique of nipple reduction is usually preferred as it assures that the nipple will be completely flat.


3)      Nipple reduction surgery is a simple office procedure done under local anesthesia. There is no recovery or physical restrictions after the procedure.


Dr. Barry Eppley

Indianapolis Indiana

Nipple Reduction Surgery for Women and Men

Sunday, February 22nd, 2009

Large nipples may be long and protruding or merely have a very wide diameter. In either case, such prominent nipples are bothersome to women or men because they can be seen through clothes. Whatever the cause, correction is done for cosmetic reasons and to look a chest or breast look that does not stand out in clothes. Enlarged nipples rarely cause pain or any nipple discharge issues.


Nipple reduction can be done by several different simple methods, depending upon the shape and length of the nipple and to what degree of reduction that the patient wants. One method involves removal of the top of the nipple in a v-shaped wedge and then closing it with small dissolveable sutures. Another method involves removal of a strip of skin around the neck of the nipple which when sutured closed, reduces the height of the nipple by pushing a portion of the nipple back into the breast tissue. With either method, feeling in the nipple is not usually changed and the ability to breast feed is possible. The top reduction method can reduce the length of the nipple the most while the strip reduction method is designed to have the least potential for any effect on nipple function. Once reduced, the shortened nipple length will be preserved forever.


Nipple reduction surgery is a simple procedure that can be done under local anesthesia in the office. Once injected, the procedure is painless and done in less than one hour. Small incisions are made right on the nipple and the excess nipple tissue removed. Dissolveable sutures are used so there is no need for suture removal later. Band-aids are used for dressings. While easily done alone in the office, nipple reductions can also be done with other breast procedures such as breast augmentation, breast reduction, or breast lifts. When combined with these procedures, they are done in the operating room with the main breast procedure.


There really is no recovery with nipple reduction. One can return to work or any other physical activity the same day. Showering and getting the nipples wet can be done the next day. Other than some mild nipple sensitivity, there is no swelling or bruising of any consequence.

Nipple reduction produces a very natural appearing nipple that causes less protrusion in clothes while maintaining feeling.


Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

Read More

Free Plastic Surgery Consultation

*required fields

Military Discount

We offer discounts on plastic surgery to our United States Armed Forces.

Find Out Your Benefits