Areola Reduction & mastectomy - which approach is safer for nipple survival?

Hi. If you undergo areola reduction first and then undergo mastectomy a few months later, the nipple will have a better chance of survival. Generally speaking, mastectomy cuts majority of the blood supply to the nipple and keeps only a small fraction of the original blood supply. However, when you perform areola reduction, you cut some of the the blood supply to the nipple but you maintain a large portion of it. As healing takes place, the remaining blood vessels get augmented because there is more demand on them. This is called the "Delay Phenomenon." Subsequently, when you undergo mastectomy, another portion of the blood supply is cut off but the remaining blood vessels have been augmented and therefore the nipple has a better chance of survival.