Areola Reduction With Scarring- Revision?

Question

Hi i had a BA and areola reduction didn't really work out cause the areola stretched back and now i have minor scars around the areola and its looks stretched, anyways is there any one that i can fix this i don't wanna go to back to my surgeon even though he said he would do it for free. I don't care about traveling as long as some one can fix this!! I want my areolas 4 cm. Also i don't want the snoopy dog appearance. If it can't be accomplished i just want the scar revision so its clean :S

Richard H. Tholen, MD, FACS · Answer

Circumareolar incisions always leave visible scars, some good, and others bad. The amount of length discrepancy between the outer incision (and its larger circumference) and the inner incision (with its smaller circumference) directly impacts the degree of scalloping and irregularity in the closure and the final scar quality. Add to that the fact that living skin stretches as it heals, and you have the result your photograph shows.

	Use of a permanent Goretex "blocking" suture (soft, and minimally stretchy) will decrease the tendency for periareolar scars to stretch and widen over time, but you can also expect some degree of areolar or breast flattening from this type of (minimal) "lift."

	Other kinds of breast lifting may be recommended to decrease the degree and/or severity of sagging or "snoopy-dog" deformity, ranging from crescent lift (worthless, IMHO), to repeat periareolar lift (you've seen how that works out; why I'm not a big fan), to vertical lift (for an example, click on the link below), to full Wise pattern (anchor) lift with the attendant scars. You probably don't need the full lift based on your present appearance, so I'd recommend the periareolar scar revision with Goretex "blocking" suture at this point in time. All the other options remain available to you if you wish, and as time goes by. Good luck!

Aaron Stone, MD · Answer

Not knowing what you started with or exactly what was done at surgery it is impossible to say what should be done now. What you are asking for may not be possible with your current breast implant size, you may have to downsize them. The most important thing you can do is get copies of your records including before surgery pictures and operative reports so that prospective surgeons can look at them and then give you relevant recommendations on how to proceed forward.

	Donut removals of skin around the areola are notorious for stretching out the areola when the donut of skin is too large. It should be obvious that if you do another donut removal of skin you will end up with an even worse result. Just cutting out the scar and closing it is a donut shaped removal of skin and so would be inadequate.

	I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

	My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Gary M. Horndeski, MD · Answer

Hi,

	Unfortunately, because of the weight of your implants, your areolas will inevitably stretch. I like using a special suture that minimizes the stretching. This seems to help a great deal. Scarring depends on two things. Your body's ability to heal and technique of your plastic surgeon. Hope this helps.

Darryl J. Blinski, MD · Answer

Overexposed flash photo hides your issues, please re post a better photo. Revision can be done using better sutures and suturing techniques.

Steven Turkeltaub, MD · Answer

You indicated that you had a breast augmentation and areolar reduction but was the latter part of an attempt to lift up droopy breasts? Are your implants above or below the muscle? Is there drooping still present right now?

	These are some of the questions that would need to be answered in order to provide you with the most appropriate recommendations and prognosis for outcome - short and longer term. The short, general answer is that an areolar reduction can clearly be performed to reduce the size. The durability of effect would be dependent on the surgical technique and sutures used as well as implant size and location above versus below the muscle.

	If you presently also have drooping which you seemed to intimate from your question, then the areolar reduction would need to be part of some sort of lifting procedure that involves more extensive incisions. You would be best served by obtaining consultations from 2 or more reputable board certified plastic surgeons in your area and assessing their recommendations

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Areola Reduction With Scarring- Revision?

Answers (7)

Answer: I Had Rhinoplasty About 8 Months Ago

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Answer: Unhappy with recurrence of enlarged areolars following breast surgery

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