Why does the areola on African American women look significantly darker and unnatural after a breast lift (mastopexy)?

hello thank you for your question and provided information as well.. based in your question its difficult evaluate you if the case dont have a picture, my recommendation is get  a consultation in person with a plastic surgeon to discuss all about theme.

It appears darker because the areola skin is not stretched out any longer.    I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

The
technique I use is The Bellesoma Method. 
This is based on a central mound, which provides better blood supply to
the nipple then the pedicle techniques.  Vertical
scars used in the lollipop and anchor techniques place tension on the areolas, cause
unnatural distortion and ischemia.  The
Bellesoma Method avoids vertical scars, nipple sensation and the ability to
breast feed are maintained.  Your breast tissue
is reshaped creating upper pole fullness without implants, elevated higher on
the chest wall and more medial to increase your cleavage.  The areolas do not look unnatural or
darkened.  Best Wishes,Gary Horndeski, M.D.

Dear scifimania,it can be caused by scar tissue. For scars, I close all of my incisions in 5 layers and do not use absorbable sutures because they cause inflammation and worse scarring. I tape all of my incisions in the office visits once a week for six weeks after surgery to improve the appearance. After taping, I start my patients on a scar gel therapy for 3 months that they have to put on their incisions twice daily.You should discuss your concerns with your plastic surgeon as different surgeons have different approaches in scar management.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hi scifimania, Abnormally pigmented scars are an undesirable consequence of cutaneous wound healing and are a concern for every single patient, but especially those with darker skin (higher Fitzpatrick skin types). Pigment production is complex and under the control of many extrinsic and intrinsic factors and patterns of scar repigmentation are unpredictable. The most important factors that we are in control of are not smoking, not exposing scars to sun and using topical rx silicone products to reduce hypertrophic scars. Factor we are not in control are genetic. Scars look different on different skin tones because there are actually two types of melanin; eumelanin, a brown-black pigment found in higher ratios in darker skin types and phaeomelanin a red-brown pigment found in people with fair skin types. Darker skin tones will have brown scars, lighter skin tones will have red scars. Trying to regulate this pigment is complex. Topicals like hydroquinone will help sometimes. After they have fully matured over the course of year and are still highly pigmented, some patients are candidates for laser. Hope that helps!

Thank you for the good question.
There are many factors involved when it comes to the exact "scarring" you see on different photographs. Sometimes, there is a difference because every plastic surgeon may have a different approach to placement of incision lines and exactly how the operation is performed. On the other hand, scars may differ because of different patient body types and because patients scar differently. Again, there are many variables involved.
Always best to communicate your goals, concerns, and questions directly with your (carefully selected) plastic surgeon.
Best wishes.

It is hard to diagnose exactly what you are referring to without a picture or physical exam but in general women with darker Fitzpatrick skin types can have hyperpigmentation or hypopigmentation of scars and the areola.  This is caused by inflammation, deposits of melanin and scarring.  It can be permanent and it can also be temporary.  The best way to avoid these complications is by having meticulous closure using non inflammatory sutures, using skin care/sun protection and pre and postoperatively, and by preserving the vasculature to the nipple.  Women who smoke are at higher risk of this complication.  That being said, even with the best precautions this can still happen.  

Dear Sci Fi Mania,Hello and thank you for your excellent question.  You may want to look into the Bellesoma Breast Lift technique - it provides an exceptional breast lift, upper pole fullness, relief from neck and back pain, and no vertical breast lift scar. It uses a woman’s OWN breast tissue to produce an internal suspension technique, without the need for a breast implant. It does not disturb the nipple, areola, or breast glands, so sensation and the ability to lactate is preserved. It uses 3D scanning of your breasts and body to design a procedure specifically designed for YOU, and you alone. Finally, for patients who desire breast enlargement, it can be combined with fat grafting. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Texas “Top Doc” 2017, 2018

RealSelf100

America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 - 2018