Easy Method for Reduction of Nipple Height

This report presents an easy method for reducing nipple height with a buried purse-string suture. A total of 38 nipple reductions were performed for 19 women. After the desired projection was determined, the nipple was marked for the extent of resection. A horizontal circle at 130 to 140% of the desired nipple height was drawn on the circumference of the nipple. The nipple was pulled away from the base of the nipple with a traction suture. Following the incision through the marked line, nipple bulk was dissected from the core of the nipple. Nipple tissue was excised piece by piece, starting from the periphery and proceeding toward the center, around the circumference of nipple. A buried purse-string suture with absorbable suture brought the remaining flaps closer together and reduced nipple diameter. The knot was deeply buried under the tip of the approximated nipple flap. For 14 patients (28 nipples) of 19 patients (38 nipples), the final nipple height ranged within 90 to 110% of the intended height at the last follow-up visit after a mean period of 18 months. Of the 19 women, 14 were satisfied with the final nipple height. The authors' surgical method is primarily aimed at reducing the nipple height and has some limitations in reducing the diameter of the nipple. However, circumferential resection of the nipple core effectively reduces muscle bulk in the remaining nipple and has a secondary effect of reducing nipple diameter.