Reduction of the Hypertrophic Nipple Using the Crown Flap Technique

Abstract

Nipple hypertrophy (macrothelia) is a condition that has been shown to cause social and psychological difficulties in affected women. For women who have no future desire to nurse and who feel that their nipple hypertrophy is aesthetically unpleasing, a nipple reduction can be a useful surgical procedure. The procedure can be easily combined with other breast surgery such as breast augmentation or can be done as a stand-alone procedure. This chapter describes the crown flap technique for nipple height reduction. This innovative procedure allows for easy reduction in nipple height with excellent maintenance of nipple shape and contour. Using our technique, a nipple reduction can be carried out in the office setting or more commonly as a combination procedure done in the operating room. The results are a uniformly reduced nipple size that is more appropriate for the patient’s breast shape and size. Nipple sensation is typically maintained but lactation is disrupted. The flaps heal very well without any prior evidence of ischemia or necrosis by either author.