Tuberous Breasts Had Periareolar Mastopexy with Permanent Sutures. Areola Still Too Big? What's the Limit for Areola Reduction?

Doctor Answers (6)

Doughnut mastopexy limits the amount of areolar resizing.

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A more conventional mastopexy incision allows for predictable decrease in diameter of the areola. The doughnut mastopexy is really not the proper operation for this particular goal.


Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

Tuberous Breasts Had Periareolar Mastopexy with Permanent Sutures. Areola Still Too Big? What's the Limit for Areola Reduction?

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     If the areolae are still too large, the periareolar mastopexy can be done again provided this will not create too much wrinkling around the areolae.  The best option may be a vertical lift to create a smaller amount of tension on the areolae and preserve the best shape.  This is a bit difficult to provide advice without photos or a physical exam.   Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts and breast lift revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 180 reviews

Areola Still Too Big

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There are way too many variables to respond to your question without at least photos. 

Since you have permanent sutures, it would seem that the size has been the same since surgery, but is larger than you feel is best for you. 

The areola can certainly be made smaller, but the technique may need to be different--that is, a vertical lift may be a better choice, depending on how mucy size change is in order, and upon the relationship of the areola to the breast skin and breast tissue. 

A photo might help, otherwise an in person consultation is your option for additions opinions. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

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Areola reduction

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Areola reduction can be performed if you feel they are too big. There is no exact standard for the diameter of the areola but there are "cookie cutters" that most surgeons use to size the areolas.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

How small can a nipple be reduced with periareolar pexy ?

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The more appropriate question is, "should I be converted to a vertical scar technique?"  

Spreading of the nipple areola is a  common problem with periareolar techniques even with permanent suture. While your surgeon may feel a revision is in order, I have found that most of the time conversion to a vertical technique takes the tension off the areolar suture line and stops the spreading without having to reduce the areola to a little disc . Even though  the trade off is the vertical scar, i have found that the shape is usually better. Have a discussion with your surgeon and he or she will help you make the right decision. 

Grady B. Core, MD
Birmingham Plastic Surgeon
5.0 out of 5 stars 2 reviews

Reduce Areola Further after Breast Surgery for Tuberous Breasts?

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You will find that online consultants will not be able to provide you with specific/precise enough answers to your question. How small areola can be reduced to will depend on factors such as quality of skin elasticity,  tension on the breast skin envelope, size of breast implants... As you can imagine, these characteristics will vary from one patient to another.

 Given your concerns, you may benefit from in-person consultation with a few well experienced board-certified plastic surgeons in your area.  Be careful about undergoing additional surgery;  weigh the pros/cons, as well as potential risks/complications, carefully in your decision-making process.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 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.