Nipples

A normal nipple typically has a conical or cylindrical shape and is located in the central part of the areola. Its surface is slightly wrinkled, and the color can range from light pink to dark brown, depending on the skin phototype, age, and hormonal balance.

Most common physiological features:

• size and length: from a few to several millimeters,
• color: naturally darker than the breast skin,
• reactivity: ability to contract in response to cold or tactile stimuli,
• symmetry: small differences between sides are normal.

Anatomical variants considered normal:

• flat nipples,
• inverted nipples (from birth),
• accessory nipples (polythelia), usually located along the so-called milk line.

It is important to distinguish congenital features from acquired changes - the latter more often require diagnostics.

Nipples can be the site of both benign and serious pathological changes. The dynamics of symptoms and their nature are of key importance. Most common abnormalities:

• cracks and erosions – often during lactation or with dermatological diseases,
• inflammatory states – manifested by pain, redness, and discharge,
• papillomas and hyperkeratotic changes – usually benign,
• nipple discharge (bloody, serous, purulent) – always requires diagnostics,
• sudden retraction of the nipple – an alarming symptom.

Changes requiring particular vigilance:

• unilateral ulceration or crusting,
• itching and burning resistant to treatment,
• change in color or texture of the nipple skin,
• deformation of the nipple appearing in a short period.

In such cases, there is no room for speculation – a medical consultation and differential diagnostics are necessary.

Correction of nipple size can be functional, aesthetic, or psychological in nature. It most commonly concerns patients after pregnancy and breastfeeding, but also individuals with congenital abnormalities or asymmetry.

Nipple Reduction:

• Indications: excessive length or width of the nipple, discomfort, aesthetic issues,
• Method: surgical shortening and modeling of the nipple,
• Effect: maintaining a natural appearance while improving proportions.

Nipple Augmentation:

• Indications: flat or atrophic nipples,
• Method: surgical reconstruction or regenerative techniques,
• Effect: improved nipple projection and breast harmony.

Each intervention requires an individual assessment of anatomy, the patient's plans (e.g., breastfeeding), and realistic procedural possibilities.

Procedures performed on the nipple-areolar complex include surgical procedures and minimally invasive methods aimed at correcting the shape, size, position, and quality of the tissues. Procedural intervention is applied only after ruling out pathological changes and in situations where abnormalities are congenital, post-traumatic, or acquired.

The most commonly used procedures include:

• surgical correction of the nipples – involving reduction, shortening, or reconstruction of the nipple while preserving its natural anatomy,
• treatment of inverted nipples – involving the release of the nipple and restoring its proper projection,
• regenerative treatments for the skin of the nipple and areola – aimed at improving elasticity, tension, and tissue quality,
• removal of benign superficial lesions – such as papillomas or hyperkeratotic changes, after prior diagnostics.

These procedures are usually performed under local anesthesia and are characterized by a short recovery time. The choice of method depends on the type of change, anatomical conditions, and the patient's plans, including potential breastfeeding in the future.

These procedures in many cases significantly improve the quality of life, self-esteem, and functioning of patients. The condition for safety, however, is proper medical qualification and the performance of the procedure in a specialized facility.