Current surgical techniques for nipple reduction: A literature review

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Reconstructive Surgery

Background:

• Macrothelia, or enlarged nipples, is an uncommon condition causing significant psychological distress.
• There is a lack of comprehensive comparisons regarding surgical techniques for nipple reduction.
• This review aims to summarize current practices for guiding surgical approaches to macrothelia.

Purpose of the Study:

• To comprehensively review and compare various surgical techniques for nipple reduction (macrothelia).
• To summarize current practices and guide the surgical approach to macrothelia.
• To identify outcomes, complications, and patient satisfaction associated with different nipple reduction methods.

Main Methods:

• A literature review was conducted using the PubMed database.
• Search terms included various combinations of nipple/areola plasty, reduction, hypertrophy, macrothelia, and techniques/classification/treatment.
• Thirty articles, including case reports and clinical observations, were selected based on inclusion criteria.

Main Results:

• Thirty articles describing techniques for nipple reduction in 639 patients (582 female, 57 male) were reviewed.
• Five distinct techniques were identified: circumcision, amputation, wedge resection, simple grafting, and flaps.
• High patient satisfaction rates and low complication rates were reported, with limited documentation on sustained breastfeeding ability.

Conclusions:

• All reviewed surgical techniques for nipple reduction yield high patient satisfaction and low complication rates.
• Significant diversity in current practices and the absence of a common classification system complicate comparisons between techniques.
• Individual patient assessment is crucial for selecting the appropriate surgical technique, and clinical guidelines are challenging due to study heterogeneity.