Ideal anatomy and proportions :

The ideal areola is 38-45 mm in diameter. The nipple should be centered at the areola and should be 10-15 mm in diameter and 5-10 mm in projection.

Some patients have sagging nipples, nipples that are too large or areolas that are too wide. All these anomalies, which can be a source of great complexity, can be corrected by surgery.
Concerning sagging nipples, they can be corrected with hyaluronic acid or fat (lipofilling).

Technique :

Hyaluronic acid : filling with a needle for more precision after local anesthesia
Lipofilling : fat harvesting (often inner knee or abdomen) under local anesthesia (no pain with an appropriate anesthesia), decantation and specific preparation of the fat (thus recovering part of the purified fat, rich in stem cells) and then reinjection by the same technique as hyaluronic acid.

Results :

Time frame for final results :
Hyaluronic acid: immediate
Lipofilling: 7-10 days after a period of swelling

Longevity of results :
Hyaluronic acid: 3-12 months
Lipofilling: 5-10 years

Before surgery :

Stop smoking 1 month before lipofilling
Do not take Aspirin 10 days before surgery, inform Dr. Lucas of any anticoagulant medication (Sintrom, Coumadin, Eliquis, etc.) to arrange for its discontinuation or replacement.
Take Arnica capsules 5 times a day for 5 days before surgery to prevent hematoma.
Contraindications hyaluronic acid: autoimmune diseases, pregnancy, breastfeeding.
Contra-indications lipofilling: pregnancy, breast feeding

Intervention :

Pain : pain during the procedure will be almost non-existent, with an appropriate anesthesia
Duration of the procedure: 25 minutes for hyaluronic acid, 45 minutes for lipofilling
Anesthesia : local
Location : office for hyaluronic acid, operating room for lipofilling
Ambulatory (without hospitalization)

After surgery :

Post-operative pain : 1/10 often responding to Dafalgan

Social eviction :

Hyaluronic acid: no (discrete swelling for 24-48h)
Lipofilling: swelling and hematoma for 4-7 days
Suture removal: no sutures
Return to work: immediate
Return to sports: 2-3 days

Instructions :

Desinfection with Merfen disinfection for 7 days.
Preventive antibiotic therapy Augmentin 1 g twice a day for 3 days.
Do not compress the fat injection zone if lipofilling (risk of fat loss) for 3 weeks.
Shower from the 2nd day: for 10 days do not rub the nipple, dry with a clean cloth by dabbing.
Stop smoking permanently to prevent fat and hyaluronic acid resorption.
Lyman 50,000 IU cream twice a day on fat collection areas.
Dr. Lucas control 2 days, 1 week, 3 weeks, 3 months.

Complications :

  • Infection, hematoma, asymmetry, under or overcorrection.
  • Intravascular emboli
  • Breastfeeding: there is no consequence on breastfeeding, the patient can breastfeed after a breast augmentation by prosthesis

Alternatives and operations that can be combined:

Nipple augmentation can be combined with breast augmentation.

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