Areola Reduction Without Augmentation or Lift? (photo)

Dear Camilla, Technically and unfortunately, the answer is no.  When you reduce the amount of skin that envelops your breast in any fashion, it lifts your breast.  I believe what you are asking is, can you reduce the size of the areola without all the scars associated with a lift and without an implant.  Then, of course, the answer is yes. 

Reducing the size of your areola with minimal scarring can be done by using several of the components present in the Benelli mastopexy.  The concept here is to make an outer circle at the edge of your areola, and normally, I use an inner circle that measures about 38mm.  Then I undermine inferiorly, laterally and medially, then bring the tissue up and put in a permanent circumareolar suture to inhibit the areola from spreading and the circumareolar scar from spreading.  The process of moving the outer circle (edge of your existing areola) to the inner circle (new edge of your smaller areola) is a process of lifting and repositioning, not just pulling. 

Your picture shows your areola are asymmetric now, the left being larger than the right, and your left areola is lower than your right.  You have the option of keeping this asymmetry, but if you want the final outcome to be symmetric, there would be slightly more lift on the left.  

To keep scarring to a minimum, I recommend once all the sutures are out around your areola and all the scabs are gone, then tape your areola 24/7 for approximately 3 months to decrease the chance of spreading and/or scarring.  I also recommend wearing a good support bra 24/7 for approximately 3 months as gravity pulls even on your small breasts, and the greatest tension is at 12 o'clock on the newly created smaller areola. 

You are a perfect candidate for the circumareolar or Benelli areolar reduction.  You, of course, need the services of a Board Certified plastic surgeon certified by the American Board of Plastic Surgery and very experienced in the Benelli surgery.

From the submitted photos it does appear you would be a candidate for areola reduction. Because your nipples are above the level of the breast fold a full mastopexy is not indicated. The next step is to visit with a board certified plastic surgeon near you for an evaluation and to learn more.

The average diameter of the areola should be approximately 4.0 centimeters.  Based on your picture, you appear to have fairly average-looking areolae.  While you could reduce the size of the areolae, the trade-off would be a scar around the periphery of the areola.  You have to decide which you would rather have - your areolae as they appear now or smaller areolae with a scar around them.

It's important to consider your options and then decide the best course of action. You should do this in consultation with a board certified plastic surgeon. Some options you might consider are areola reduction alone, areola reduction and breast implant placement and may be just a breast augmentation. Best wishes, Aldo.

The least amount of scarring related to areola reduction is a circumferential scar at the border of you areola. There would not be a significant breast lifting by itself. Your breast shape may be slightly flattened. How the final scarring will appear can be variable from person to person. Unless you truly dislike the size of your current areola, the tradeoff of surgical scar and breast shape change may cause some people to hesitate about the decision to proceed.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

It is possible to decrease the circumference of the areola. This will result in some change in your breast shape, usually some flattening when done without and implant.  From your photos, your areola do not seem abnormally large and I would recommend not doing anything - you will probably hate the scar and breast shape change more than you dislike your areolas now.