Information About Areola Reduction

just want to no how its done, how much it costs and whats the recovery like.I would only like it done to one of my areolas.also where do i find someone to do this is either san francisco or milwaukee area.thanks!

Doctor Answers (13)

Areola Reduction

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A youthful, aesthetically ideal breast has an areolar diameter of about 38-42mm (about one and a half inches). Some breasts have large areolas from the time that they develop during puberty, and some enlarge later in life with pregnancy and lactation. A large areola tends to make a breast look 'matronly' even if it is not droopy. Areolar diameter can definitely be reduced, and this can be performed as a stand-alone procedure or as part of larger cosmetic breast procedure such as a lift, reduction or augmentation.

The surgical technique involves removing the excess areolar skin, in the form of a donut-shaped skin excision. A circular incision is made around the areola at the desired diameter of about 40mm, then a second circular incision is made at the outer border of the large areola. The epidermis is shaved off between the two incisions, leaving the dermis behind. A 'purse-string' suture is then placed in the dermis at the outer incision that allows the surgeon to reduce the outer diameter to 42-44mm by cinching together the two ends of the suture. The suture acts as a drawstring to reduce the outer diameter, and allows closure of the areola with reduced tension on the healing incision.

The purse-string suture is critical for maintaining areolar shape and size. Without the purse-string suture, areolas will almost always enlarge over time. When that suture is tied, the skin of the outer portion of the areola is gathered somewhat, as the circumference of the outer incision is much larger than that of the inner incision. The gathered or 'pleated' appearance of the outer margin of the areola gradually flattens out over time; this generally take a few months.

Occasionally I see a patient purely for areolar reduction, but the majority of patients I see have their areolas reduced as part of a mastopexy (breast lift), augmentation mastopexy (breast lift plus implant placement), or breast reduction procedure. The circumareolar scar (scar all the way around the areola) usually heals very well and is camouflaged by the color difference between areolar skin and breast skin, but if you are going to have a scar around the areola you might as well do something to improve breast shape and/or size at the same time. Keep in mind however that most breast lift and reduction procedures require a vertical scar from the bottom of the areola to the inframammary fold (crease below the breast), and in some cases a scar in the inframammary fold as well. A word of caution: many surgeons perform what they call a 'circumareolar' (or 'donut' or 'Benelli' ) mastopexy. In my opinion there is absolutely no such thing as a 'circumareolar mastopexy'. Removing skin around the areola may enable a surgeon to elevate the position of the nipple/areola complex perhaps 1-2 cm on the breast mound, but it DOES NOT lift the breast itself. In most cases, unfortunately, it serves to distort the shape of the breasts, making them appear flattened at the top. If the breast needs to be lifted, it absolutely requires some internal rearrangement of breast tissue to create a projecting, aesthetically ideal and lasting result - which in turn requires that vertical incision and vertical surgical scar below the areola (and sometimes in the inframammary fold as well.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 38 reviews

Areola Reduction?

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Thank you for the question.

Areola reduction  involves  circumferentially removing areola  skin  around a smaller areola design. This procedure can be done under local or general anesthesia. It is often  done as part of a brest augmenation/lift,  breast lift or  breast reduction  procedure.

Patients should be aware that despite best efforts scarring will be visible and potentially abnormal ( possibly thick, raised and/or pigmented).  Some areola  asymmetry may also  be present after surgery.   Their  is  a small chance that  a patient may lose sensation.

As with all plastic surgical procedures, patients must weigh the potential benefits against the potential risks/complications  while making decisions.

You will be best served to seek treatment by a board-certified plastic surgeon (check with the American Society of Plastic Surgeons)  who can demonstrate a significant level of experience  with the procedure you are planing.  You can ask to see his/her before-and-after pictures and to potentially meet with patients who've had similar surgery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 701 reviews

Areolar reconstruction

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Areolar reconstruction can either be performed under local or sedation anesthesia. For a plastic surgeon in your area, consult the website of the American Society of Plastic Surgeons. Cost would vary depending on the condition being addressed and the length of the procedure. You haven't explained why this is only required unilaterally in your case so I cannot evaluate the etiology of the condition.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Areola Reduction and Recovery

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Areola reduction can be achieved with local anesthesia or under light sedation.    The recovery should be relatively pain free and the biggest inconvenience will be needing to keep the area dry during the initial healing period.   Cost will depend on the amount of areola to be removed.

Carlin Vickery, MD
New York Plastic Surgeon
5.0 out of 5 stars 3 reviews

Areolar reduction

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An areolar reduction is performed by making an incision around the border of the existing areola and then excising the excess areola in the shape of a donut. A drawstring like stitch (usually permanent) is placed just below the surface of the skin on the outer circle. This is pulled snugly until the outer circle matches the size of the inner smaller circle. The skin is then repaired with stitches. Costs tend to vary from $2000-5000. Recovery requires limited activity for 3 weeks.  

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 43 reviews

Reducing the Areola

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As mentioned by all the prior posters, this procedure is relatively simple and can be done in the office under local anesthesia.  It will involve the use of a pursestring type suture so expect wrinkling that usually will resolve in most without need for more intervention.  By having an areolar reduction, you will also get some lifting of the breast which could be a perk for you.  Select a qualified surgeon and you should have a satisfactory outcome.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

Areola reduction

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To reduce the size of the areola, a periareolar donut of pigmented skin is removed from the outer aspect of the redundant areola. You can check the American Society of Plastic Surgeons or American Society of Aesthetic Plastic Surgery for referrals in your desired areas. 

Hayley Brown, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 20 reviews

Reduction of the Breast Areola

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Reduction of the breast Areola is a relatively easy procedure which requires removal of the outer areola down to the desired size and then advancement of the surrounding skin to the remaining areola.

You should consult with a Board Certified Plastic Surgeon to do the surgery in either of the cities that you mentioned.

Walter D. Gracia, MD
Arlington Plastic Surgeon
5.0 out of 5 stars 2 reviews

Areolar reduction surgery

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The size of the areola can be reduced with a relatively simple surgical procedure.  Basically a doughnut ring of areola skin would be removed.  The standard areolar diameter is 37 to 42mm,  The diameter for your larger areola would be determined by the shape and size of your opposite side.  An incision is made along the outer edge of the areola and a second incision is made based upon the desired size.  The doughnut of skin is then removed.  The only potential problems with this technique is a white scar at the outer edge of the areola and potential widening in the future.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Areola reduction

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Hi Unhappygal,

The procedure to reduce the areola usually involves making an incision around the perimeter and then within the areola at the new circumference.  So you will have a scar at the new edge of the areola; this usually heals well.  One thing to be aware of is that the border will be very defined and this will be different from the unoperated side, so the surgeon will be very careful to match the shape of the non-operated areola as much as possible.  Cannot comment on fees as these vary greatly in different geographic areas and also by doctor.  Patients who have asymmetries corrected are usually very happy.  You can find a board certified plastic surgeon on plasticsurgery.org.  Also, ask friends, doctors, hospitals, nurses, etc. who does a lot of breast surgery in your area.  Surgeons who do both reconstructive and aesthetic breast surgery will be more than capable of helping you with this.  Good luck.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 17 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.