Nipple and Areolar Reduction in Men

Q: My boyfriend is concerned about the size of his areolas. Do you offer areola reduction surgery? He is very interested because he feels his nipples stick out too far and his areolas are too wide. They stick out when he is in t-shirts and some clothes.

A: The nipple and areola, known in plastic surgery as the nipple-areolar complex, is a two-tiered structure. Surrounding a central protruding and darker pigmented nipple, the areola is flat and much larger in diameter. The size of this complex can be quite variable with significant amounts of nipple protrusion and very wide areolas. But the extent of these variations is largely in women since this is a functioning gland that changes as a result of pregnancy. Men rarely show such variations in size as it serves no functional purpose.

Todays’ fashion and styles, however, have placed a little more focus on the nipple-areolar complex. Men do not like when their nipple protrudes through clothing and, rarely, a few men feel that their areola is too wide. Most wider areolar concerns are in patients with gynecomastia where the breast is also larger. But wide areolas can occur when gynecomastia is not present. In women, the typical areolar diameter measurement is around 38 to 45 mms. In men, those numbers are usually half those amounts.

Both nipple and areolar reductions are simple procedures. The nipple protrusion can be flattened by a simple wedge excision without any visible scarring. The areolar diameter can be narrowed by a circumareolar excision. This does leave a fine line scar at the junction of the areolar and skin. Both can be done under local anesthesia in an office setting.

Dr. Barry Eppley