Can fat grafting reduce the appearance of my herniated areolas?

Question

Dual plane BA 2016, mild tuberous. I will have a revision surgery subglandular placement due to severe animation deformity. Operation will involve fat grafting to provide better coverage/contour - I don't have much tissue medially & cleavage appears flat/square. (Sutures in right IM fold never held & this malpositioning will be fixed too). Don't like how my areolas look pokey but I don't want them incised - is it possible to lessen their protrusion by grafting fat around them?

Alejandro Nogueira, MD · Answer

There are deep diagnostic shortfalls in your case and a misled corrective / surgical approach; I'll try to clarify some concepts:
-well likely you were not mild tuberous, yours was a medium to high tuberous breast deformity; with this in mind any tuberous breast specialist knows that areola herniation can be treated ONLY by a combined approach of: a) glandular plasty to reduce the conicity and b) periareolar skin reduction to tighten in and flatten out the areolas, or a combination of the former both; in your case it is SURE no one of these procedures have been applied, undisputably, because: a) glandular plasties of tuberous breasts can ONLY be done through areolar access, never feasible by underneath incisions, and b) it is obvious you have no perimetral scars around the areola; conclusion: you received NO treatment for your tuberous breast deformity, therefore it is obvious you still keep a large amount of such deformity, and now it is up to you deciding if you accept its correction (paying the scar price) or just leave the herniation as it is, but for sure there is NO OTHER surgical option to flatten your herniated areolas, like fat grafting or other "creative and trendy" surgical fashions... the only state-of-the-art approach is the one I have mentioned: glanduloplasty and periareolar incision
-the animation deformity does not (necessarily) require plane change to subglandular; nevertheless the change should be to subfascial and NOT to subglandular, since subfascial, if used with latest generation macrotextured implants, does not lead to capsular contracture, and subglandular is more prone to capsular contractur and bottoming out; the correction of the animation requires a well done partial submuscular (aka dual plane) technique, if you have animation means the muscle was not properly or sufficiently freed from ribcate, submammary skin fold or both, in other words: a technical error; so the solution might be equally valid: correct submuscular techcnique revision or plane relocation to subfascial
-I strongly advise you against fat grafing in general (a fraud with disappointing or null, even dangerous, outcomes), much less on a breast (may interfere breast mammograms and cancer diagnosis) and very much less if implants are nearby (you may lose them due to fat necrosis, get puncture on them, etc). Furthermore, it is unclear the reason why you are supposed to need fat grafting on your breasts, it is unexplained, anyhow don't get it
-your implants set low, you have a moderate bottoming out (or alternatively the implants' pocket was tailored too low), this needs a combined approach of: a) ultra adhesive latest generation of macrotextured implants (anatomical shapes are better if possible) with b) submammary fold raise by means of a multipoint capsulorrhaphy, a very difficult technique which is pretty common in breast revision specialists
Best advice is seeking other opinions by revision specialist who do not offer fat grafting or minimally invassive options, or just stay like you are now since it is not that bad result, seems accetable, not perfect but neither a bad case.

Steve Merten, FRACS - Account Suspended · Answer

Hi, I don't think fat grafting around the edges of the areolae will work. The only way to correct this problem is to either make an incision around the outside and stitch it tighter (which will give a scar) or possibly by removing breast tissue from the inside, which would be difficult and may not work.
Regards, Dr Steve Merten, Sydney, Australia

Can fat grafting reduce the appearance of my herniated areolas?

Answers (2)

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

Can fat grafting reduce the appearance of my herniated areolas?

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.