Marina del Rey
Dr. David Stoker
4640 Admiralty Way #1000
Marina del Rey, CA 90292
A common complaint for women is that they have enlarged or asymmetrical areolas, especially following breastfeeding. The areola is the pigmented region of the breast that surrounds the nipple. It is also common for men and women to complain of puffy areolas. They are typically most prominent when the patient is warm and when the smooth muscle of the areola is not constricted. Depending on the extent of their problem, there are several different nipple surgery options for Los Angeles patients.
The most common nipple and areola conditions that I treat include:
Having performed thousands of breast operations, I've developed significant skill in nipple and areola surgery. I have published some of my specialized experience in medical literature.
Inverted nipples are a problem I commonly treat in my practice. Inverted nipple repair may be performed under local anesthesia with minimal discomfort for the patient. I leave most of the breast ducts intact, allowing the possibility that the patient may breastfeed in the future. Men also benefit from this minimally-invasive procedure with quick recovery and minimal scars.
For puffy areolas, the treatment is different for women than for men. Normally, for women, I will want to maintain the breast ducts so that she may be able to breastfeed if she chooses. Typically, I'll remove an outer ring of areola skin, preserving the underlying ducts and nerves. I then stitch the inner aspect of the ring to the outer aspect using a meticulous technique. This creates some tension across the areola, flattening it. Another treatment for puffy areolas is breast augmentation. Typically, I recommend breast implants only for patients who want larger breasts because the previously described procedure is very effective even without implants.
Enlarged areolas are a different problem, but the surgical treatment has some similarities to the treatment of puffy areolas. If the patient also may benefit from a breast lift or reduction, I routinely reduce the size of the areolas in those procedures to create optimal proportions for the breast.
If the enlarged areolas are an isolated problem, I use a direct surgical treatment. This involves removing an outer ring of superficial areolar skin, leaving the breast ducts and nerves intact. I place a permanent stitch around the circumference of the outer ring (we call it a "purse string" stitch) and tighten it so that the larger outer ring of skin is made smaller to match the inner ring. The procedure is the optimal way to improve the aesthetic appearance of a breast with enlarged areolas.
It is common for men and women to seek improvement for nipples that are excessively long or wide. Long nipples in males are particularly bothersome because they are visible even through clothing. I have expertise in an innovative procedure I developed to reduce male nipples without a visible scars using local anesthesia. For women it is also common to have prominent nipples, especially after breastfeeding. Women most often benefit from a circumferential reduction of the nipple to decrease projection and droopiness. I also perform female nipple reduction under local anesthesia for the convenience of our patients.
Prominence of breast tissue in men is called gynecomastia, and the degree of gynecomastia varies considerably among patients. Puffy areolas in men are best treated surgically. Most commonly I make a small incision on the lower aspect of the areola and remove a disc of breast tissue from behind the areola. The amount of tissue is usually similar in size to two quarters and a nickel stacked on top of each other, but this amount varies depending on the patient's particular situation.
For men who have enlargement of the breasts that extends beyond the areolas, I will also perform power-assisted liposuction to flatten the chest. The breast tissue behind the areola becomes more defined and may then be removed through an even smaller incision on the lower aspect of the areola. In either case, the incisions typically heal beautifully and are very discreet.