Areola Reduction Surgery: What You Need to Know

Pros

• If you're concerned about the appearance of your areolae, areola reduction surgery can resize and reshape them—making an oval-shaped areola rounder, for instance.
• The surgical procedure takes less than an hour and can be performed under local anesthesia (unless it's combined with a more invasive breast surgery).
• Recovery is relatively quick, too. Many people head back to work after only 1-2 days. 
• Results are long-lasting and can even be permanent. 
• Areola reduction should not affect the feeling in the nipple-areola complex. You may have a temporary loss of sensation during the healing process, but it's rarely permanent. 
• The procedure has a solid 86% Worth It Rating. RealSelf members who say their procedure was Worth It report feeling greater confidence with their more proportional, smaller areolas. 

Cons

• Though the incision around the areola often heals very well and scars can be improved with scar treatments, scars may still be noticeable.
• Areolae can stretch and widen again over time due to breastfeeding, hormonal changes, aging, or significant weight loss or gain.   
• Rare complications include loss of sensation in the nipple and an inability to breastfeed.
• For people who have excessive sagging, reducing the size of areolae can flatten the projection if it's done without a breast lift.

• Average Cost:
• $2,925

• Range:
• $1,500 - $6,650

Your cost will depend on the experience level of your surgeon, their practice location, and whether you're combining your procedure with another breast surgery. This may require general anesthesia, which is more expensive than a local anesthetic.

"Areolar reduction prices vary greatly due to a number of variables, including the different techniques that can be performed," says Dr. Larry Nichter, a plastic surgeon in Newport Beach, California. Length and complexity of the surgery is another factor that determines the cost, he says—for example, how much tissue will be removed, whether one or both sides will be reduced, and whether a lift or other breast surgery is also done at the same time.

Areola reduction is a cosmetic procedure, so insurance won't cover it, but most plastic surgery practices offer payment plans or accept financing options to help make the cost more manageable.

See our complete guide to areola reduction costs

Areola surgery takes about an hour when it's performed alone. First, you'll be given local anesthesia, possibly with IV sedation, to ensure that you'll stay deeply relaxed and pain-free throughout your procedure. 

Then “The diameter of your new areola is measured using a circular metal device referred to as a ‘cookie cutter,’” explains Dr. William Bruno, a plastic surgeon in West Hollywood, California. 

Your surgeon will make an incision along the perimeter of both your current and new areolae, carefully removing the donut-shaped piece of excess tissue. 

Your smaller areolae are then secured with permanent sutures inside your breast tissue, and the incisions are also closed with sutures, which may be dissolvable. The area is then bandaged, and you may be placed in a surgical bra to keep everything in place as healing begins. 

The surgery is performed on an outpatient basis, meaning you'll go home afterward. If the procedure was done under local anesthesia, you’ll be able to go home as soon as your anesthesia (and possibly sedation) wears off. If you received general anesthesia because your procedure was combined with other breast surgery, you’ll be monitored for a few hours in a recovery room before being released to a trusted friend or family member who can take you home.

Areola reduction is usually performed under local anesthesia, often with IV sedation, so you won't feel anything during the procedure; you’ll be very sleepy and relaxed. 

Afterward, it's common to experience mild swelling and discomfort for a few days. These side effects can be managed with pain medication, and often over-the-counter options are enough.

Most people can head back to an office job within a day or two after areola reduction surgery, but it can take up to six weeks for the swelling and numbness to fully resolve. You'll see your final results within a year, when your scars will have faded.

Expect some swelling, bruising, and discomfort, especially for the first few days after surgery. The pain is usually mild enough to be controlled with over-the-counter pain medication, but everyone is different, so have a conversation with your surgeon about pain control before you head into surgery.

Your surgeon will give you instructions on how to gently clean your incisions to reduce the risk of infection.

They may also ask you to wear your surgical bra or sports bra for the first few weeks, too, to protect your areolae and position your nipples for optimal healing. Just make sure your surgical bra isn't too tight; this can lead to side effects like skin irritation and excess swelling.

During the first week of your healing process, you’ll need to sleep on your back or a wedge backrest so you don’t put too much strain on your chest. 

After a week, your provider will remove any non-dissolvable sutures at a follow-up appointment. They'll also check on how your healing process is going.

Avoid exercise or other strenuous activity, including sex, for at least two and ideally three weeks. At that point, you should be able to safely resume your normal activities.

Your ability to breastfeed should not be affected by an areola reduction procedure that's performed by an experienced, board-certified plastic surgeon.

The supply of breast milk can be compromised by the cutting of milk ducts and nerves in the breast, according to the Cleveland Clinic, but milk ducts should remain intact during this surgery. 

That said, there is a small risk that the milk ducts can be damaged during surgery, which could compromise your ability to breastfeed. Be sure to discuss this possibility with your plastic surgeon.

This procedure is generally safe, and most patients don’t experience major side effects beyond discomfort, swelling, and bruising.

However, your plastic surgeon should explain these potential complications and how you can help avoid them. 

• Infection: Your surgeon will give you aftercare instructions, to reduce your risk of infection. 

• Scars: You will have a scar around your new areola, where the incision was made. Talk with your surgeon about whether they’d recommend a scar treatment to help it fade.  

• Sensation changes: You may have a temporary loss of sensation around your areola. In rare cases, this can be permanent.  

• An inability to breastfeed: As mentioned above, it’s possible for the milk ducts to be damaged when excess areola tissue is removed. While this is a very rare complication, it’s another good reason to wait until after breastfeeding to move forward with the procedure.