No, your nipples are not removed when you get breast implants. In a standard breast augmentation, the nipple and areola stay exactly where they are, fully attached and with their blood supply intact. This is one of the most common misconceptions about the procedure, likely caused by confusion between cosmetic augmentation and mastectomy reconstruction, which are very different surgeries.
Where Incisions Are Actually Made
Surgeons use one of three incision sites to place breast implants, and none of them require removing the nipple. The most common options, as outlined by the Mayo Clinic, are the inframammary approach (a small cut in the crease under the breast), the transaxillary approach (through the armpit), and the periareolar approach (along the edge of the areola).
The periareolar incision is probably the source of the confusion. It involves a cut along the border where the darker areola skin meets the lighter breast skin. The surgeon works through this opening to create a pocket behind the breast tissue or chest muscle, then slides the implant in. At no point is the nipple detached, lifted off, or removed. The incision simply follows the natural color transition line so the scar blends in afterward. Surgeons are careful not to undermine the tissue directly beneath the nipple, specifically to protect its blood supply.
Why Mastectomy Reconstruction Is Different
The idea that nipples get removed likely comes from breast cancer surgery. During a mastectomy, the entire breast is removed, and in some cases the nipple and areola are removed with it. After the breast is rebuilt using implants or tissue from another part of the body, a new nipple can be surgically recreated in a later procedure.
Some women qualify for a nipple-sparing mastectomy, where the nipple and areola are preserved depending on the tumor’s size and location. But this is cancer surgery, not cosmetic augmentation. If you’re getting implants purely for size or shape, mastectomy techniques don’t apply to you at all.
What Happens to Nipple Sensation
Your nipples won’t be removed, but it’s reasonable to wonder whether they’ll feel the same afterward. The nipple and areola get their sensation primarily from branches of the third through fifth intercostal nerves, with the fourth being the most important. These nerves run through the breast tissue, and placing an implant can stretch or temporarily irritate them.
In the first few months after surgery, it’s common to notice changes in nipple sensitivity. Some women experience heightened sensation, others feel numbness, and many report tingling or occasional shooting pains as the nerves recover. According to the University of Utah Health, these odd sensations typically settle within the first couple of months.
The numbers are reassuring. In one study tracking sensation recovery, 92.5% of women regained their normal breast sensation within 12 weeks of surgery. Only 4% of nipple-areola areas had not returned to baseline sensitivity by that point. So while temporary changes are common, permanent numbness in the nipple is relatively uncommon with standard augmentation.
Does Incision Type Affect the Nipple?
You might assume the periareolar incision, being closest to the nipple, would carry the highest risk of sensation problems. The research doesn’t support that. One large comparison found no change in nipple or skin sensation in the periareolar incision group (610 patients), while a small change in nipple sensation was detected in the group with incisions below the breast (over 9,200 patients). The overall negative effect of either approach on nipple sensation was rated as low.
Breastfeeding outcomes tell a similar story. About 47% of women with an incision below the breast and 46% with an areolar incision continued to breastfeed successfully, with no statistically significant difference between the two. Another study of 115 women found no meaningful difference in breastfeeding outcomes based on incision type or implant placement. The nipple’s milk ducts and nerve connections remain functional in the vast majority of cases regardless of where the surgeon makes the cut.
Implant Placement and the Nipple
Where the implant sits inside the breast can matter more than the incision location. Implants placed in front of the chest muscle (prepectoral) have a slightly greater effect on milk production compared to those placed behind the muscle (retropectoral). This makes sense anatomically: an implant sitting directly behind the breast gland can put more pressure on the tissue and ducts than one tucked behind the muscle layer.
For women concerned about future breastfeeding, the behind-the-muscle placement offers a small advantage, though the overall impact of either position on nursing ability remains modest. If breastfeeding is a priority, it’s worth discussing implant placement with your surgeon before the procedure.
Rare Complications Involving Nipple Tissue
Tissue death around the nipple (necrosis) is a risk that comes up in breast surgery discussions, but it’s primarily associated with mastectomy and reconstruction, not cosmetic augmentation. In one study of patients who had nipple-sparing mastectomy with flap reconstruction, 44% experienced some degree of tissue breakdown, with smoking history being a significant risk factor. Former smokers with longer histories were substantially more likely to develop complications.
In routine breast augmentation, where the breast tissue remains intact and the blood supply to the nipple isn’t disrupted in the same way, this type of complication is far less common. Still, smoking impairs blood flow to skin and tissue in any surgical context, so quitting well before any breast surgery reduces your risk across the board.