How Much Areola Reduction Can Be Achieved with a Nipple-based Incision?

Hi, I have a question about areola reduction.

I've heard that an incision can be made around the base of the nipple so that scarring will be less visible, but that the amount removed is less than other incisions.

How much exactly can be removed using the incision at the base of the nipple?

Doctor Answers 4

The limits of surgery done with only a nipple incision.

Limiting the incision (and resultant scar) limits the amount of nipple/areola reduction and skin tightening that can be done.   It has been my experience that an incision around the nipple can reduce the areolar diameter by about 1/3 or it can lift the areola about 1/2 inch.  It cannot do both.  When too much is attempted with this limited  incision, the breast ends up with a weird, chopped off shape, like an Aztec pyramid as opposed to an Egyptian pyramid.  I always go for the shape.  If the shape is lovely, the scars are worth it.  If the shape is weird, well, the shape is weird.

This opinion, by the way, is based on learning the hard way!

Lisa Lynn Sowder, M.D.

Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Areola reduction with a nipple-based incision


There are many different options to reduce the size of the areola with surgery. And incision may be made around the outer perimeter of the areola or around the base of the nipple. You will be able to reduce the size of the areola more significantly with an incision around its perimeter. Keep in mind that you run the risk of nipple sensation with an incision around the base of the nipple itself.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

Areola reduction

If you're considering an areolar reduction, this can be done under local anesthesia.

The diamater of your new areolar is measured using a circular metal device referred to as a "cookie cutter". Once the smaller inner circle diameter is determined, the outer "excess" skin is removed then a permanent suture, such as Gore-tex, can be used to create a smaller, long-lasting diameter areola. The final layer of stitches are absorbable. This can be done in less than an hour with very minimal downtime.

Please see a board certified plastic surgeon to determine the best procedure for your specific case.

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 reviews

Reduced only by incision all the way around

The peri-areolar incision is not necessarily less visible than other scars. If you want an areolar reduction with your breast augmentation a smaller diameter marker (called a cookie cutter) is used to mark the smaller new areolar size and the outer, larger diameter is marked as well. The intervening skin (like a small donut) is removed and the implant can typically be placed through a deeper incision in the raw area. Once the implant is in place, the outer circle is closed around the smaller inner circle often with a permanent suture. This is a breast augmentation with areolar reduction.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.