Aesthetically Ideal Areola Size, How to Calculate

Yes, you are right there are many different sizes of areolas depending on the person. I ask my patient to bring in examples of what size they find aesthetically pleasing. Then based upon their anatomy i discuss what options are available. There are many different ways to make an areola including using your own tissues or tattooing . The best thing to do is make sure you are consulting with a board certified plastic surgeon.Hope this helps

You are correct in saying a "normal" aesthetically pleasing areola is 35mm-48mm. However, this isn't always true for everyone. You are correct in discsussing a ratio, however, there is no specific algorithm that will give you the "perfect" areola size. Its up to your surgeon to decide what size fits your body frame as well breast size. This is a discussion to have with your surgeon prior to any surgery.

This can depend on the patient's preference. There is an an average size which will vary with the size of the breast, and the patient can have input into the final diameter. 

There is no ideal size!  Plastic surgery is an art and science.  This falls under art.  This is a personal choice.  If you want a very large or very small areola then that is what you want.  Your surgeon can share their experience and their preference.  At the end of the day it is your choice.  Find photos of what you like.  Share that with your plastic surgeon.  That is far more valuable than any calculation.  Ideally your plastic surgeon's goal is to make your vision come true, not their own.

As you accurately mentioned the ideal areola size range, the ideal being around 4.2 cm. This size however should be proportional to the rest of the breast, mainly the volume and the location of the areola, as well as the nipple reconstruction. This is also a matter of personal taste, as some patients prefer smaller areola, and others want to restore the same size as they had prior to mastectomy. This is definitely something that you need to discuss with your plastic surgeon in detail to make sure you are pleased with the final result