Looking at the areola after breast surgery, small raised bumps can suddenly seem obvious, especially when the colour and shape of the areola have changed. These are Montgomery tubercles — the Montgomery glands, sebaceous glands of the areola, projecting to the surface. They protect the nipple and areola, but when they are large or prominent they become a cosmetic concern. The answer is not to squeeze them or shave the surface, but to consider the gland tissue that forms the bump.
Contents
What are Montgomery tubercles?
They are small, slightly raised bumps on the areola around the nipple, where Montgomery glands open to the surface. They produce a sebaceous secretion that protects the skin of the nipple and areola and reduces dryness and friction. Number and size vary between people, and they can become more prominent with hormonal change, pregnancy or breastfeeding.
After breast surgery, a change in breast shape and volume can make areolar bumps look more noticeable. Breast surgery itself does not necessarily cause them — existing tubercles often simply become more visible with the change in shape.
Because they are a normal structure, not all need removing. Where size or projection causes real cosmetic discomfort, the decision is made in consultation.
In a photographic analysis of 211 patients (399 breasts), Montgomery tubercles averaged 5.0 per breast and ranged from 0 to 25 — a normal structure, so only prominently projecting ones are selected for treatment.[1]
Why should they not be squeezed?
Because the bumps look like pimples or sebaceous plugs, some try to squeeze them or pierce them with a needle. But a Montgomery tubercle is not sebum accumulated on the surface; it is connected to gland tissue sitting within the skin. Forcing pressure can injure surrounding skin and cause inflammation or infection, and even if some contents are expressed, the gland remains and the projection returns.
Shaving off only the projecting part, or burning the surface with heat, likewise focuses on reducing the bump while leaving the gland beneath. Removal therefore has to account for the position and depth of the tissue forming the tubercle, not just flatten the surface.
How does an insulated needle remove them?
Where projection is pronounced, a specialised radiofrequency insulated needle can be discussed. A fine, insulated needle is inserted into the centre of the tubercle and RF energy is delivered to the target tissue. What separates this from ordinary surface treatment is selective destruction: the aim is the gland tissue forming the bump, not the removal of its surface layer.
The sequence runs as follows:
- Step 1 — Assessment: the size and shape of the projecting area are examined to confirm it is a lesion that needs treatment.
- Step 2 — Preparation: the sensitive areolar skin is prepared and appropriate anaesthesia given.
- Step 3 — Insertion: a very fine insulated needle is placed into the centre of the tubercle.
- Step 4 — Energy delivery: heat is delivered to the target tissue, selectively treating the gland forming the tubercle.
- Step 5 — Review: surrounding skin and bleeding are checked, with aftercare explained.
Depth and energy must be adjusted to the size and position of the tubercle and the character of the surrounding skin. The areola is pigmented and sensitive, so avoiding unnecessary damage to surrounding tissue matters — and since Montgomery glands protect the areola, treatment selects problem areas rather than removing every gland.
Read alsoCriteria for removing Montgomery tubercles are covered in “Montgomery tubercles: should they be removed?” (Korean).
How is the area managed afterwards?
Minimise irritation while the areolar skin heals. Scabbing can occur, and redness or swelling may appear during recovery. Key points:
- Do not touch the treated area or pull scabs off
- Reduce friction from underwear or clothing until healed
- Follow the cleaning and ointment instructions given
- Avoid exfoliating products or irritating cosmetics before full healing
Because the areola is dark and sensitive, care should prevent inflammation, pigment change and scarring. Worsening pain, spreading redness or pus should be checked at the treating clinic.
A comprehensive imaging review of the nipple-areolar complex sets out criteria for distinguishing benign change from disease — where one side changes rapidly, differentiation comes before removal.[2]
Montgomery tubercle removal: common myths and facts
| You may think… | In practice |
|---|---|
| "Squeezing removes it at the root." | Squeezing leaves a wound and pigment change; the gland stays. |
| "Removal leaves a large scar." | A small entry point treats only the projecting gland. |
| "It cannot be done after breast surgery." | After recovery it is done in the surface layer, unrelated to the implant. |
In consultations after breast surgery I ask whether the tubercles were there before the operation. Often they simply became more prominent as the skin stretched, so timing and extent are planned together.
Montgomery tubercles are normal areolar sebaceous glands — averaging 5.0 per breast across 399 breasts — so not every one needs treating. Squeezing or shaving only damages skin and leaves the gland behind, which is why a radiofrequency insulated needle targets the gland tissue inside the tubercle through a small entry point. The areola is sensitive and pigmented, so tissue selection matters, and a rapid one-sided change should be differentiated before any cosmetic removal.
🔬 The research behind this article
These are the international journal papers that support the content above. Select a title to open the abstract on PubMed.
- American Journal of Surgery 2023 — photographic analysis of 211 patients, 399 breastsKandi LA, Hammond JB, Thornburg DA, et al. Can Montgomery tubercles impact aesthetic 3D nipple-areolar complex tattooing? An anatomical, quantitative analysis of breast cancer patients. Am J Surg. 2023;225(1):99-102.Key: Montgomery tubercles average 5.0 per breast (range 0–25)Text [1] · PMID 36404166 · DOI
- Clinical Radiology 2021 — comprehensive imaging review of the nipple-areolar complexLyons D, Wahab RA, Vijapura C, Mahoney MC. The nipple-areolar complex: comprehensive imaging review. Clin Radiol. 2021;76(3):172-184.Key: criteria for differentiating benign and malignant lesionsText [2] · PMID 33077158 · DOI
🎬 Watch: Dr. Park Seong-Soo on video
Korean-language videos from BongBong Plastic Surgery's official channel and Dr. Park's channel, “Seongsu-ro Doctor”. Titles are translated for reference; selecting one opens YouTube.
- Montgomery tubercles prominent after breast surgery: removing them at the rootSeongsu-ro Doctor · 2026.06.09
- Areolar bumps that stand out after breast surgery, removed smoothlySeongsu-ro Doctor · 2026.06.13
- Why you should never squeeze Montgomery tuberclesSeongsu-ro Doctor · 2026.06.11
Frequently asked questions
Are all bumps on the areola after surgery Montgomery tubercles?
A. No. Montgomery tubercles are normal sebaceous gland structures, but folliculitis and cysts can look similar. If they grow suddenly or come with pain, discharge or persistent inflammation, have them checked.
Can I squeeze Montgomery tubercles at home?
A. It is not advised. Pressure or piercing can damage skin and cause inflammation or infection, and the projection can return if gland tissue remains.
How does the insulated radiofrequency needle work?
A. A fine insulated needle is inserted into the centre of the tubercle and RF energy treats the target tissue — addressing the tissue forming the bump rather than shaving the surface.
Can scarring occur after removal?
A. Scarring or pigment change can occur depending on depth, extent and how the skin heals. The areola is sensitive, so appropriate scope and aftercare matter.
Will they come back after removal?
A. Recurrence depends on whether the target tissue was adequately treated. Remaining or neighbouring glands can project again, so the planned extent and expected change should be discussed beforehand.
📖 References
Select a [number] in the text to jump to the source, and ↩ to return. Only papers whose title, journal and year were verified on PubMed are included.
- Kandi LA, Hammond JB, Thornburg DA, et al. Can Montgomery tubercles impact aesthetic 3D nipple-areolar complex tattooing? An anatomical, quantitative analysis of breast cancer patients. Am J Surg. 2023;225(1):99-102. — American Journal of Surgery 2023 — photographic analysis of 211 patients, 399 breasts. ↩
- Lyons D, Wahab RA, Vijapura C, Mahoney MC. The nipple-areolar complex: comprehensive imaging review. Clin Radiol. 2021;76(3):172-184. — Clinical Radiology 2021 — comprehensive imaging review of the nipple-areolar complex. ↩
BongBong Plastic Surgery · Dr. Park Seong-Soo, Medical Director
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