Should I get an areola reduction? (Photo)

Question

I dislike how large and puffy my areolas are and the cone shape of my breasts. I've seen some people with similar breasts to see have an areola reduction and it pushes the herniated tissue in, fixing the shape of the breast. Would this last long term? Will it go back puffy or stretch out? Would permanent stitches prevent stretching? Am I a good candidate?

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Since you are from my old hood (I am from Aurora), I wanted to help out and answer your questions. The answer is that you have a condition called tuberous breast deformity. This is where the breast has some constriction during development that does not allow the lower part of the breast to develop normally during puberty and this results in a shortened and flat lower pole of the breast, an elevated fold position, enlargement of the areola, and herniation of the breast tissue into the nipple/areola (due to the fact that it cannot drop normally into the lower part of the breast.  All of that to say that while we term this a "deformity" it is not dangerous and does not have to be corrected. It does not affect the function of the breast and is a cosmetic deformity only compared to what we consider an "ideal" breast shape. It is common to have it more severe on one side than the other and this seems to be the case for you as well. The shape of the breasts and the constricting bands is often addressed at the time of breast augmentation for patients who want to enlarge the breast at the same time. In addition, the addition of an implant can help stretch the lower pole of the breast and provide additional shaping. You can achieve some shaping with fat transfer but it is less predictable. If you are happy with the breast size and shape and just want to correct the areola herniation, that can be accomplished with a peri-areolar mastopexy, but this will not alter the shape of the lower breast. Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Wayne I. Yamahata, MD · Answer

You should be able to achieve the breast shape you desire with an areolar reduction or mastopexy. This does result in circumareolar scars that can be prominent. If you elect to proceed to a consultation, ask your surgeon to show you examples of the scars. Since you are trading one condition for another, this can help you to decide on the "lesser of two evils."

Daniel Barrett, MD · Answer

Dear Reliable191652,
it is hard to tell for sure without an examination. Based on your photos, there is a chance that your breasts are tuberous. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

Unfortunately with an areolar reduction you often trade one problem for another. Namely scars around the areolae that often don’t heal very well. I’m
Not sure it’s worth it

Camille Cash, MD · Answer

From the photos it appears your breasts are constricted.  A mastopexy can help improve the shape of the nipple.  If you are considering a small implant that could help improve the overall shape of the breast when combined with the mastopexy.  The next step is to visit with a board certified plastic surgeon near you for a consultation to learn more.

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