Dr. Karen Horton has either authored or reviewed and approved this content.
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Whether due to genetics, life changes, or breastfeeding, many women seek cosmetic nipple surgery to feel more confident and comfortable in their own skin.1 This specialized category of breast procedures includes inverted nipple correction and nipple reduction, both of which are performed by Dr. Karen Horton, a Board-Certified Plastic Surgeon serving patients throughout the San Francisco Bay Area and greater California. These procedures can improve nipple appearance, restore function, and be performed alone or as part of a larger cosmetic surgery plan, such as a Mommy Makeover, breast augmentation, or breast lift.
Cosmetic nipple surgery refers to minor surgical procedures designed to correct nipple inversion, reduce nipple size, or improve symmetry. These techniques are customized based on each patient’s goals and anatomy and may be performed alongside other breast surgeries, such as breast reduction, gynecomastia treatment for men, or reconstruction following breast cancer.
You may be a good candidate if you:
Before your procedure, Dr. Horton will conduct a detailed consultation, which includes reviewing your medical history, discussing your goals, and performing a physical evaluation. Preoperative instructions may include discontinuing certain medications and preparing for a few days of downtime.
If you are taking GLP-1 medications—including semaglutide—for diabetes or weight loss, these must be discontinued at least one month prior to any surgical procedure involving general anesthesia, and one week before surgery planned under local anesthesia. Continuing these medications can increase the risk of serious anesthesia-related complications. Learn more about how to stay safe when undergoing breast or cosmetic surgery while taking GLP-1 medications in our blog post.
Inverted nipple correction can involve just one or both nipples and affects up to 20% of the population.2 Women with inverted nipples may face embarrassment or self-consciousness, or may have functional difficulties with breastfeeding or erogenous sensation. Some women note their nipples are increasingly inverted after they have finished having children; nipple correction can also be part of a Mommy Makeover. Inverted nipple correction surgery addresses these issues by releasing tight fibrous bands beneath the nipple that cause retraction.
During inverted nipple repair, congenitally tight bands that extend from the breast to the nipple base are divided. A small incision is made at the base of the nipple at its junction with the areola, the colored circle surrounding the nipple, and the tight bands are released. Milk ducts and nerve connections are preserved as much as possible.
Depending on the degree of inversion, the surgical procedure can take 30 minutes to an hour to perform. Dissolving internal sutures are used. Surgery takes place under local anesthesia in our San Francisco Plastic Surgery center, and downtime is a few days. After surgery, a soft, absorbent dressing is applied, and Dr. Horton may recommend using a foam “donut” nipple splint for a few weeks.
Patients with overly large or elongated nipples may opt for a nipple reduction to achieve a more normal, natural appearing nipple.3 Like the correction of inverted nipples, this surgical procedure is offered as an office outpatient procedure and takes up to an hour to perform. A small incision is made at the base of the nipple. Dissolving sutures are hidden beneath the nipple, and the nipple is made smaller and less prominent to suit your specific wishes. Sensation and the ability to breastfeed should remain after surgery.
After nipple correction (whether for correction of inverted nipples or size reduction a soft foam “donut” is often worn over the nipple to protect it during healing. One will be placed over the nipple after surgery, and patients are sent home with a few extras to wear as protection during the first week or two after repair.
Nipple reduction can also be part of a Mommy Makeover. If additional pregnancies are planned, it is best to wait until after nursing is complete for nipple reduction surgery.
For more information, please read our blog Nipples & Plastic Surgery – What is normal, what can be changed?
Most patients return to normal activities within a few days. You may experience mild swelling or sensitivity, which typically resolves within a short period. Recovery includes wearing the protective foam donut shield and following Post-operative care instructions to support smooth healing and reduce scarring.
After photos will be taken during follow-up appointments to document healing and outcomes.
Will I have scars after nipple surgery?
All surgical procedures involving incisions will result in some degree of scarring. However, with nipple surgery, the incisions are typically small and strategically placed at the base of the nipple, where they blend naturally with the surrounding areolar tissue. Most patients find that their scars heal well and become barely noticeable over time.
Are my nipples normal?
Many patients ask this question, and the truth is, there’s a wide range of what’s considered normal when it comes to nipples and areolas. From inverted nipples to hairy areolas, and even bumpy textures caused by Montgomery glands, these variations are far more common than you might think. In fact, most of what people worry about—like asymmetry, areola size, or nipple direction—is completely normal and often related to genetics, pregnancy, breastfeeding, or aging. That said, if a nipple concern affects your comfort, confidence, or function, there are safe and effective surgical procedures available, including inverted nipple correction surgery and nipple reduction, that can help. To see illustrations and learn more about what’s normal (and when to consider treatment), read the full blog post here.
Can I combine other treatments with cosmetic nipple surgery?
Yes. Many patients choose to combine nipple surgery with other cosmetic surgery procedures, such as breast augmentation, breast lift, or breast reduction, or for a more complete enhancement. Some even include liposuction, abdominoplasty, or skin care treatments as part of a Mommy Makeover for full-body rejuvenation. Dr. Horton will help you determine the safest and most effective treatment plan during your consultation.
Where can I find cosmetic nipple surgery near me?
Dr. Karen Horton is proud to offer cosmetic nipple surgery to patients in the San Francisco Bay Area. As a highly experienced and artistic woman Plastic Surgeon in California, Dr. Horton combines surgical precision with a compassionate, patient-centered approach to help you achieve natural-looking results. Contact us today to book your consultation.
1 American Society of Plastic Surgeons. Cosmetic procedures for the nipples and areolas. https://www.plasticsurgery.org/news/blog/cosmetic-procedures-for-the-nipples-and-areolas. Accessed June 4, 2025.
2 Cleveland Clinic. Flat and Inverted Nipples. https://my.clevelandclinic.org/health/diseases/25118-flat-and-inverted-nipples. Accessed June 4, 2025.
3 Canadian Journal of Plastic Surgery. Nipple reduction – An adjunct to augmentation mammaplasty. https://pmc.ncbi.nlm.nih.gov/articles/PMC2740602/. Accessed June 4, 2025.
Dr. Karen Horton has either authored or reviewed and approved this content.
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Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the Pacific Heights District in the Pacific Professional Building.
Monday-Friday: 9am - 5pm
Saturday-Sunday: Closed
Monday:
9 AM to 5 PM
Tuesday:
9 AM to 5 PM
Wednesday:
9 AM to 5 PM
Thursday:
9 AM to 5 PM
Friday:
9 AM to 5 PM
Saturday:
Closed
Sunday:
Closed
Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
SHOP SKIN CARE*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
