Is there a procedure to smoothe very bumpy nipples (Montgomery glands) surgically and re-positioning areolas? (Photo)

You need a formal breast lift with a lollipop type incision to elevate and medially position the nipples.   The Meibomian glands can easily be reduced by a very small excision over each one..which would heal with a negligible scar.

Thank you for your question and photos.Unfortunately, 'smoothing' the Montgomery glands on the areolas is not recommended. Any attempt to excise or dessicate them may incur undesired complications such as infection, scarring or waxy substance to grow into tissue. Montgomery glands as you may already know do provide an important role - maintaining areolas soft and supple.In addition to your areolas being too lateral, your breasts are also positioned laterally and would need to be repositioned also. A simple augmentation will not correct this. A successful technique called The Horndeski Method (TM), can reshape, lift and reposition the base of the breast with minimal scarring. Please know that implants cannot lift breasts or change their position. Please visit the breast implant revision forum on this site to see common complications associated with breast implants when used to lift breasts.I hope this helps.Best wishes,Gary Horndeski M.D.

If you want the areola to be more centralized, it might be accomplished with a a lift.  Implants will make the breasts larger.  The small glands can sometimes be removed individually but would leave little scars.

I agree with some of the other responses, if you want the breasts bigger get an implant, if you want the same size just a better shape nd areola position then a vertical Breast lift may be the right operation.  If you do implants with a lift then still a vertical or maybe a periareolar lift may help reposition the nipples.  While it is relatively easy to elevate nipples, it is actually trickier to move them medially as some of the post up ingay be due to your chest wall.  As to the montgomery gland smoothing, there is no way to smooth them. And excision is going to leave lots of little scars.  Certainly when the nies are repositioned a significant number of the glands around the periphery will be excised.  Again, it is so difficult to make any definitive comment without an in person exam but I hope this helps!

Your photos are not sufficient for a conclusive surgical opinion but they do suggest that you may have sagging breasts.If you are otherwise happy with your breast cup size / the way they fill you bra and all you want is perkier breasts, then all you may need to consider is a Breast Lift (MASTOPEXY).On the other hand, if you wanted them LARGER you would need to add volume to each breast (Breast Augmentation or fat transfer ) AND have a Breast Lift to reposition the nipple areola complex to a central position on the breast mound.I would NOT operate on Montgomery's tubercles at the same time. You are asking for a higher risk of complications including poor scarring and infections.Good LuckPeter A. Aldea, MD

First of all the nipples are in the correct position on the breasts, i.e. they sit at the apex of the breasts, but the breasts flare out. Correction of this would require a breast lift or reduction.Although I have never treated prominent Mongomery Tubercles I would suggest a trial of wither cutting out one or two, a simple procedure under local anesthesia, to see what the results look like and/or using a laser or electrical cautery to "burn" one or two off and see the results. If it works nicely do the rest. If not leave them alone.