Large Areolas and Droopy Nipples. What Breast Surgery Do I Need?

I am uncomfortable & embarrassed of my breasts b/c of my big aereolas, and I would like my nipples to be higher up. Im wondering if I need just aerola reduction, or if I need a lift and/or implant too. What do you think? The first 2 photos are me, and the last 2 photos are what I want my breats to look like (natural). What do I need to do to get to my goal breasts? Thank you!!

Doctor Answers 28

Breast Lift or Not?

It is common to compare ourselves to others, as you are doing.

Your two photos do not suggest that you are as "bad" as you feel.

I would advise giving surgery plenty of thought as any areolar or other type of breast lift will create scars that you may end up being more unhappy with.

Miami Plastic Surgeon
5.0 out of 5 stars 4 reviews

Large Areolas

Dear Hanna G,

I will begin by telling you that what you perceive as a source of embarrassment - ie. your areola, are not that unusual or large.  I would suggest you think long and hard before pursuing surgery, as the scars from any suggested surgeries may result in poorer cosmesis.

Nonetheless, if you really wanted to have surgery, an areolar reduction with a peri-areolar mastopexy technique could be used.  The downside of this technique is that it may make your breast appear more boxy.  In addition, the scar around your areola may widen with time.  

Speak with one or two experienced plastic surgeons in your area and go over the pros and cons of all proposed procedures.  Think about it long and hard - I think your breasts are better off without any intervention at this time.

Warmest Regards,

Asif Pirani, MD, FRCS(C)

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 32 reviews

Smaller areolas

From what you write in your note the size you want to be is similar to where you are now so simply doing a donut mastopexy to make your arelar complexes smaller is all that may be needed.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 44 reviews

Breast Lift with Areolar Reduction

Hello and thank you for the question.

In review of your photographs and given consideration of your desired results, I would offer you a vertical mastopexy ( lolli-pop scar breast lift). This will afford you both a breast lift for the moderate ptosis, which your breasts have as well an areolar reduction to a size that is better proportioned to your breasts. I recommend you consult with a Board Certified Plastic Surgeon who has ample experience in breast rejuvenation surgery.

Best of luck,

Glenn Vallecillos, M.D., F.A.C.S.

Glenn Vallecillos, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 21 reviews

Areola reduction, breast lift, or augmentation?

If you are happy with your breast size, there is no need to perform an augmentation with breast implants. Because you have droopy or sagging breast, I recommend a breast lift or mastopexy. I don't think a periareolar lift would be sufficient. A mastopexy would reduce your areolas at the same time.

Breast lift

Hello, and thank you for this question. Based on your pictures I feel a minor lifting procedure may be in order. You could certainly obtain some improvement with a doughnut-type mastopexy. If you would like to have more cleavage and more fullness smaller implants may need to be placed. That would also depend on your native skin tone and skin elasticity which could be  evaluated in a  formal evaluation and physical examination with a qualified plastic surgeon.

John J. O'Brien, Jr., MD
Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 14 reviews

Areola Reduction

This is a good question that is very common in my practice. The periareolar mastopexy would give you a very good result as you only need a small lift. This will limit the scar to just around the areola, which tends to hide very well as it is at the natural transition of your areola and breast skin. This would also allow your surgeon to decrease the size of your areolas. The combination of the periarealar mastopexy and implant will give patients like yourself a very good result.

You do want to make sure that if you decide to go with a periareolar mastopexy or Benelli lift that you do the procedure with someone that has a lot of experience in this procedure as there are subtle technical details that make a big difference in the outcome of your surgery.

Consult with your board certified plastic surgeon to discuss the surgery.

I hope this helps, you look like a great candidate for a breast lift with implant and will likely have a great result!

Depends on your goals

Your goals will dictate the surgical plan.  A breast augmentation could be performed.  It would depend on what you are trying to achieve.

Large Areolas and Droopy Nipples. What Breast Surgery Do I Need?

If you are happy with the size of your breasts and desire the areola to be smaller and the nipple and breast tissue higher on the chest, you likely would be happy with a breast lift (mastopexy).  The down side to any breast lift procedure is that you will have permanent scars on your breasts. 

Brian Kreul, MD
Medford Plastic Surgeon
5.0 out of 5 stars 7 reviews

Areolar reduction and uplift

You can have an areolar reduction and uplift. The trade off is permanent scars and no one can honestly guarantee the quality.

Genevieve MacDonald, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.