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Nipple & Areola Reduction

Surgery to improve the appearance of large, long, or droopy nipples and overly large or puffy areolas can enhance the size and shape of your breasts. Dr. Paul G. Ruff IV, M.D., FACS specializes cosmetic breast enhancement procedures such as nipple or areola reduction. In Washington, D.C., Dr. Ruff works with you to get excellent results that achieve your cosmetic goals.

If you're insecure about the size of your nipples, the dark area surrounding them, or both, request a consultation online to meet with Dr. Ruff at his Washington, D.C. office to discuss whether nipple or areola reduction surgery is appropriate for you. Or call our office at (202) 785-4187 to speak with a member of the Ruff Plastic Surgery staff to schedule a consultation.

Paul G. Ruff IV, M.D., F.A.C.S.

Inspiration sparks passion. Passion nurtures excellence. Dr. Paul G. Ruff IV, inspired by his grandfather, knew at an early age he wanted to help people as a doctor. Dreams do come true.

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Paul G. Ruff IV

Before & After Photo Gallery

We're as thrilled with our patients' results as they are. Check out our before-and-after photo gallery and see for yourself the kind of work our talented surgeons do.

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Are You a Good Candidate for Nipple or Areola Reduction?

If you are in general good health and have a clear understanding of the limitations and potential results of your nipple or areola reduction, you are an ideal candidate for the procedure.

Meeting With Dr. Ruff

At your consultation with Dr. Ruff, he provides a clear understanding of the procedure, as well as an accurate picture of how your breasts will look after the surgery.

Dr. Ruff and his staff at Ruff Plastic Surgery will:

  • Outline in detail what you can expect before, during, and after the procedure
  • Clearly discuss the potential risks of the procedure
  • Provide detailed cost and payment information
  • Answer all your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medications you currently take, including over-the-counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

How the Procedure Is Performed

Your nipple or areola revision procedure is performed in our state of the art surgical suite or at one of the area hospitals where Dr. Ruff operates. The surgery is performed under local anesthesia and generally takes about an hour to complete. You go home shortly after your surgery.

For nipple reduction, the doctor makes a small incision on the nipple itself. For areola reduction, the doctor makes an incision around the perimeter of the areola. In both cases, the incisions heal very quickly.

Once the incision is complete, the doctor removes excess tissue from the area of the incision. Stitches are then used to close the incision, and gauze dressings are placed over the breasts. A special surgical bra is placed over your breasts after the surgery to ensure that your breasts are held in the best position for healing.

What To Expect After Your Surgery

Activity When
Shower or Bath 1 to 2 Days After Surgery
Back to Work Day After Surgery
Driving 1 to 2 Days After Surgery
Physical Contact With Breasts 3 to 4 Weeks After Surgery
Strenuous Activity 3 Weeks After Surgery
Fading of Scars Several Months to 1 Year

Immediately After Your Surgery

In most cases, you will be ready to go home shortly after your nipple or areola reduction procedure. You may be drowsy after the anesthesia, and the area around the incisions will be sore, so it is important to have someone drive you home after your surgery.

The First 24 to 48 Hours After Your Surgery

During the first 24 to 48 hours after your procedure, you may feel tired from the anesthesia and sore from the surgery. Dr. Ruff will prescribe pain medication to alleviate most of the discomfort. Your discomfort level will improve rapidly after the first 2 days.

The First 2 Weeks After Surgery

You will notice a marked improvement in your discomfort level during the first few weeks after your surgery. Other things to be aware of:

  • Any bruising you experience will usually disappear in about 2 weeks.
  • You may experience some numbness in the area of the surgery. This numbness is caused by the swelling of your breasts after surgery and usually disappears within 6 weeks.
  • You may experience some tingling in the nipple-areola complex after surgery. This is a normal result of the healing process and will go away within 6 weeks of the surgery.
  • Your stitches will be removed within 5 to 7 days after surgery.

You should sleep on your back for the first week after surgery to help with the healing process. You should wear the special surgical bra placed over your breasts after surgery at all times for the first few days. A softer sports bra should be worn at all times for the first 2 weeks after surgery. The bra should be worn even while sleeping to help hold your breasts in the correct position. You may take the bra off to shower or bathe but must put it back on immediately after drying off. If the bra feels too tight, call the staff at Ruff Plastic Surgery immediately — bras that are too tight can cause skin problems.

Resuming Your Normal Routine

You are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work or school within a day of your surgery.
  • You can resume driving within a day or 2 of your surgery.
  • You should avoid sex for at least the first week after your surgery.
  • Do not go without a bra for at least 6 weeks after your surgery.
  • Strenuous exercise can begin about 2 to 3 weeks after your surgery, but remember that everyone heals at different rates so take these activities slowly until you feel ready. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • The scars on your breasts should be protected from sunlight for at least a year after surgery.

Things to Be Aware of After Your Surgery

  • The skin of your breasts may appear shiny due to swelling. Within a few weeks, the swelling will disappear and the skin will return to a normal appearance.
  • You may experience some numbness in the area of your surgery, but this generally goes away within 6 weeks of your surgery.
  • Your breasts may heal at different rates. One breast may swell, one may feel less comfortable, or the shape of your breasts may look different. This is normal, however, when your body is fully recovered, your breasts will look very similar and natural.

What Are Possible Side Effects or Risks?

Like all surgical procedures, there are risks associated with nipple or areola reduction surgery. These risks can be greatly reduced by closely following the instructions provided to you by Dr. Ruff and the staff of Ruff Plastic Surgery.

Some possible side effects include:

  • Infection
  • Loss of nipple sensation
  • Scarring

How Long Will the Results of Your Nipple or Areola Reduction Last?

Results of your nipple or areola reduction are permanent; however, keep in mind that your breasts may droop or sag over time as a natural result of the aging process.

Questions You May Have

Are there other procedures that could be done along with nipple or areola reduction to enhance the size and shape of my breasts?

Depending on the size and condition of your breasts, a breast augmentation, breast lift, or breast reduction, could be performed to enhance the size and shape of your breasts. All of these options will be discussed with you when you meet with Dr. Ruff and his staff at Ruff Plastic Surgery.

Will my insurance coverage pay for my nipple or areola reduction surgery?

Nipple or areola reduction is a cosmetic procedure and, therefore, not covered by insurance. You are responsible for the full payment for your procedure. Cost and payment options will be discussed fully with you at your initial consultation.

Are there alternatives to nipple or areola reduction surgery?

There are no non-surgical alternatives that reliably reduce nipple size or projection or areola size.

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Ruff Plastic Surgery
2440 M St NW #200
Washington, DC, 20037
(202) 785-4187
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