I had slight breast asymmetry, however this was most notable due to one areola (the right)being significantly larger than the other. I had an areola reduction on the right nipple 2 years ago, using permanent stitches. I was pleased with the results, however two years on I have noticed that the areola has stretched out - not to its original size, but I suspect it will get worse. I would like to re-do the surgery but would it just stretch again, and could the scarring be worse second time around?
Single Areola Reduction That Stretched out
Doctor Answers (5)
How close to even do areola have to be?
Your photos show a good result. Yes, your right side is slightly larger and if it continues to stretch out, you certainly can have a re-do done. I would suspect the risk for stretching out would be slightly less since your tissues have had some time to stretch out following your original procedure. Regardless, the risk of recurrence is real with this procedure.
As mentioned by others, at this point, very few doctors would recommend surgical intervention. You will decide when its bothersome enough that you are willing to accept the risks of surgery in hopes of achieving what your desire.
Repeat areolar reduction
Your areolae are still quite close in diameter so it might be best to leave them alone. On the other hand, you could repeat the reduction but it might well return to the current state after another 2 years. Maybe leave well enough alone?
Areolar stretching post reduction
Unfortunately you are experiencing what is well known about periareolar reductions. The tension of this reduction is around the periareolar area and thus with time the areola will always stretch out again and the scars can become thicker and more visible due to the tension. Unfortunately, If you repeat the procedure the same results can recur over time.
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Firstly, the photographs are too small, but the difference between the areolas does not appear great.
Secondly, you are right, even with use of permanent sutures the areola tends to stretch out, but usually not to the original size.
Finally, a revision is definitely possible. How much the areola will stretch again will depend on how much skin had to be removed. If things go well, the scar should be no worse.
Areola Reduction That Stretched out
Reducing the diameter of an overly wide areola involves removing the excess "rim" of areola and stitching the outer edge of the wound to the inner edge (=the outer edge of the new areola). This is often done with a wagon wheel like stitch closure with a permanent stitch. The problem is that there is long term tension on the closure from the outer wound pulling on the inner diameter. As a result, when the stitch finally breaks, the pull by the outer rim will stretch the areola out resulting in a wider areola. Repeating the operation may eventually result in the same result.
Dr. Peter Aldea