Areola Reduction: Risky when Done a Second Time?

Question

I have had a mini breast lift, with incision around the areolas, about 6 months ago. I find my areolas sitll pretty big for my bra size (areolas of 4,3mm for bra size 34-A). I would have liked to have them reduced to 3mm, but a surgeon told me there were more risks (skin necrosis, loss of sensibility, etc.) when doing an areola reduction for a second time. Is it really risky?

Kenneth Hughes, MD · Answer

Make sure you know exactly what was done in the first procedure.  An operative report would be helpful.  However, usually these reductions can be done again.

Martin Jugenburg, MD · Answer

Areola reduction is not a risky procedure, it does not interfere with the blood flow or nerves to the area and should not have an 'increased' risk as compared to it being done the first time around.

Jourdan Gottlieb, MD · Answer

Provided there was no significant sensory loss the first time, a second areolar reduction should pose no more threat than a first one. This revision would presumably be quite superficial--often not even the full thickness of the skin, and should not interfere with either blood supply nor innervation. 

	I would comment that 3 cm is rather small for an areola even on an A cup breast.

	Best wishes.

Steven Wallach, MD · Answer

A revision of an areola reduction usually is OK. It is best to know exactly what was done the first time.

Robert F. Centeno, MD, FACS · Answer

After six months, most of the blood supply to the nipple areolar complex has healed. Unless you have other risk factors, re-reduction of the areolas can be performed safely.  38-42 mm is within the standard range for your size breasts.  I would be concerned about possibly over-reducing the areola.  You should mark the areolas out at the final desired size to be certain that you would be happy with that small size prior to proceeding.  Good luck!

Tom J. Pousti, MD · Answer

As you know, every surgical procedure does carry some risk. Although is not possible to give you precise advice about your situation, it does not sound like the surgical procedure you are contemplating should be associated with significant risk of skin necrosis or loss of sensation.

	 Best wishes.

John Q. Cook, MD · Answer

Unless the first areolar reduction was done with an unusual technique, it should not be particularly risky to reduce them further. This can usually be done in the office under a local anesthetic. Best of luck.

Robert L. Kraft, MD, FACS · Answer

Secondary surgery has an increased risk as opposed to a primary procedure.  However, areolar reduction is a skin surgery and does not carry a high risk relatively  as it does not reach the large blood vessels.

Neil Gottlieb, MD · Answer

The reduction of the areola can be done as a skin excision, or as part of a breast lift or reduction. Although there is always risk with additional surgery, it is unlikely that further skin reduction will give any significant risk. If you healed well the first time you will likely follow that same pattern. Make sure to ask if a purse-string closure is being used, as this prevents the spreading of the healing scar. Good Luck

Hilton Becker, MD · Answer

Revisional breast surgery always carries increased risk

	However,a circumareolar revision usually only involves removal of the outer layer of skin around the areolar without cutting any large blood vessels .

	Close post operative observation should be done

Areola Reduction: Risky when Done a Second Time?

Answers (10)