Areola reduction with revision - is a lift necessary? (Photo)

Question

I currently have saline implants, and want to exchange to larger implants (either Saline or Silicone, I am still undecided). I have the subfascial placement and would like to have the implants subfascial as well., and I would like an areola reduction at time of surgery. Does it look like I need a breast lift as well? If I have my implants replaced through the areola, does an areola reduction significantly increase the cost of surgery? Thank you for your time!

Gary M. Horndeski, MD · Answer

Unfortunately,
you have not provided a side photograph but your areolas are large and need to
be reduced.  However, I would not
recommend larger implants since your breasts appear large and the additional
increase will lead to more drooping and require revision in the future.  The areolas can be reduced using a
circumareola incision. Best Wishes,Gary Horndeski, M.D.

Kenneth Hughes, MD · Answer

The areolae can be reduced, and the implant size can be increased.  An exam will be necessary to determine whether there is capsular contracture present.Try to research this to find the surgeon who consistently produces the 
results you would expect.  Look at reviews on this site and see who gets the surgery right every time.  Find

a  board certified plastic surgeon who performs hundreds of breast 
augmentations and breast augmentation 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, MDLos Angeles, CA

Gerald Minniti, MD, FACS · Answer

Hello,Agreed with Dr. Rand, your breast on the side with the grey cable is already looking 'ball in sock', whether that's due to contracture, unpredictable tissue stretch, or insufficient tissue coverage due to 'subfacial' implant placement cannot be determined.  My recommendation, especially if you are contemplating a larger implant, is to replace with silicone gel under the pectoralis muscle. This will give you as much protection, support, and tissue coverage as possible and reduce the risk for upper pole problems or capsular contracture.  A breast lift may be necessary but cannot be determined without physical examination.Your desire to pinch pennies now will come back to haunt you later if you choose ever larger, saline implants in this essentially subglandular position.  Larger, saline and high profile implants have the greatest negative effects on your tissues over a long period of time. Eventually tissue stretch and thinning will lead to deformity, malposition and severe rippling. Any or all of these issue may not be completely fixed, even with expensive surgical revisions using the latest in acellular dermal matrices. Best of luck!

Edwin C. Pound, III, MD · Answer

Based on your picture, the shape of your breasts looks good.  I don't think you need a breast lift.  An areola reduction would take a little bit longer to do than simply switching out your implants and would therefore probably cost more.  It would also result in a scar that goes all the way around your areola.  The areola reduction is essentially the same technique we use to do the periareolar (aka, Benelli or donut) breast lift so, if you wanted to lift your areola slightly, that could be done as well.

Jaime Campos Leon, MD · Answer

Thank you for the picture.I do suggest for you to have an areola reduction in order for them to be the same size, I suggest a lolly pop incision, this way you won't have any larger scars.Dr. Campos

Darryl J. Blinski, MD · Answer

Additional fees would run between $1,000 to $1,800. Best to ask your surgeon what are the additional charges...

Steven M. Camp, MD · Answer

Hi there,Thanks for sharing you pictures.  Based on what I see in the photo I can understand your concerns.  The areola certainly appear larger than is ideal, and I am concerned that you may have a capsule contracture on one side as it seems higher than the other.  I recommend a consult with a board certified plastic surgeon to examine you and discuss a surgical plan in detail.  One of the most common reasons to perform revision of a breast augmentation is to correct implant position and contracture issues.  It would be very reasonable to perform areola reduction and a small lift (periareolar) at the same time.I hope this is helpful.

Terrence Murphy, MD · Answer

Doing the Areolar reduction will add cost to an implant replacement. Weigh carefully the benefit of  an Areolar reduction against the scarring. Look at lots of pictures before going ahead. Otherwise you don't need a lift.

Brian K. Brzowski, MD, FACS · Answer

While the diameter of the areola are certainly enlarged, without examining you to know what tissue laxity exists, it is tough to know whether a reduction in the diameter could be achieved while increasing the implant size.Also, a photograph from the side will help to determine whether a breast lift is necessary.We have lots of experienced plastic surgeons here in Utah, so you are best served by coming in for a consultation and geting an expert opinion from someone who has the chance to perform a physical examination and speak with you about your options.

Rami Ghurani, MD - Account Suspended · Answer

Hi and thanks for your question. I agree with you that an areolar reduction will look better. The issue with you is more than just an areolar reduction. Obviously, without a real physical exam it is difficult to be sure. I do agree with my colleagues that there some evidence of a capsular contracture on the left breast. I think a circumvertical lift with a capsule removal will do the job. The circumareolar will not hold well under a bigger implant and tends to get wider, and it flattens you breast. The circumvertical will accomplish you desire to reduce your areolas but will also aid in coning the breast and make you perky. I don't like the flat pancake look after a periareolar lift. I know that circumvertical adds a vertical component but that scar fades with time and you will be happy with the shape that the scar will not bother you. Try to not let your decision be affected by price, there are a lot of financing options. You need to make the correct and long lasting decision. Good luck, and remember to see a board certified plastic surgeon.

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