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Dr. Paul G. Ruff IV, M.D., FACS , Dr. Amir Arsalan, and our team of board-certified plastic surgeons specialize in cosmetic breast enhancement procedures. One such procedure is nipple and areola reduction. Our surgeons are committed to providing the best option for nipple and areola reduction in Washington, D.C., working with you to get excellent results that achieve your cosmetic goals.
If you’re insecure about the size of your nipples, the dark area surrounding them, or both, request a consultation online at their Washington, D.C. office to discuss whether nipple or areola reduction surgery is appropriate for you. Or call our office at (202) 785-4187 to speak with a member of the West End Plastic Surgery staff to schedule a consultation.


Your nipple or areola revision procedure is performed in our state of the art surgical suite or at one of the area hospitals where Dr. Ruff and Dr. Arsalan operate. The surgery is performed under local anesthesia and generally takes about an hour to complete. You go home shortly after your surgery.
For nipple reduction, the doctor makes a small incision on the nipple itself. For areola reduction, the surgeon makes an incision around the perimeter of the areola. In both cases, the incisions heal very quickly.
Once the incision is complete, the doctor removes excess tissue from the area of the incision. Stitches are then used to close the incision, and gauze dressings are placed over the breasts. A special surgical bra is placed over your breasts after the surgery to ensure that your breasts are held in the best position for healing.
We’re as thrilled with our patients’ results as they are. Check out our before-and-after photo gallery and see for yourself the kind of work our talented surgeons do.
At your consultation with your surgeon, they provide a clear understanding of the procedure, as well as an accurate picture of how your breasts will look after the surgery.
Your surgeon and the team at West End Plastic Surgery will:
You will be asked to provide:
The cost of a Nipple and Areola Reduction starts at around $4,500. The price will vary depending on the extent of treatment necessary to deliver your desired results.
During your consultation, our surgeons will assess your cosmetic goals and develop a treatment plan tailored to meet them. The starting price is provided for your convenience, and it is important to note that it does not encompass facility or anesthesia fees. The comprehensive cost, inclusive of all potential fees, will be confirmed during your visit.
We also offer financing options, including CareCredit® and Alphaeon®, to help you with the cost of your cosmetic surgery.
In most cases, you will be ready to go home shortly after your nipple or areola reduction procedure.
You may be drowsy after the anesthesia, and the area around the incisions will be sore, so it is important to have someone drive you home after your surgery.

During the first 24 to 48 hours after your procedure, you may feel tired from the anesthesia and sore from the surgery. Your surgeon will prescribe pain medication to alleviate most of the discomfort. Your discomfort level will improve rapidly after the first 2 days.
You will notice a marked improvement in your discomfort level during the first few weeks after your surgery. Other things to be aware of:
You should sleep on your back for the first week after surgery to help with the healing process. You should wear the special surgical bra placed over your breasts after surgery at all times for the first few days. A softer sports bra should be worn at all times for the first 2 weeks after surgery. The bra should be worn even while sleeping to help hold your breasts in the correct position. You may take the bra off to shower or bathe but must put it back on immediately after drying off. If the bra feels too tight, call the staff at West End Plastic Surgery immediately — bras that are too tight can cause skin problems.

You are the best judge of when you are ready for certain activities, but the following are general guidelines:

Activity | When |
|---|---|
| Shower or Bath | 1 to 2 Days After Surgery |
| Back to Work | Day After Surgery |
| Driving | 1 to 2 Days After Surgery |
| Physical Contact With Breasts | 3 to 4 Weeks After Surgery |
| Strenuous Activity | 3 Weeks After Surgery |
| Fading of Scars | Several Months to 1 Year |
Like all surgical procedures, there are risks associated with nipple or areola reduction surgery.
These risks can be greatly reduced by closely following the instructions provided to you by your surgeon and the staff of West End Plastic Surgery.
Some possible side effects include:

Results of your nipple or areola reduction are permanent; however, keep in mind that your breasts may droop or sag over time as a natural result of the aging process.
Depending on the size and condition of your breasts, a breast augmentation, breast lift, or breast reduction, could be performed to enhance the size and shape of your breasts.
All of these options will be discussed with you when you meet with Dr. Ruff, Dr. Arsalan, or one of our surgeons and their staff at West End Plastic Surgery.

Nipple or areola reduction is a cosmetic procedure and, therefore, not covered by insurance.
You are responsible for the full payment for your procedure. Cost and payment options will be discussed fully with you at your initial consultation.

There are no non-surgical alternatives that reliably reduce nipple size or projection or areola size.
If you’re in the Washington, D.C. area and considering nipple or areola reduction surgery, contact West End Plastic Surgery.
Request a consultation online or call our office at (202) 785-4187 to schedule a consultation.