Hi. I am an 18 year old female under going a BA and Areola reduction. I am currently a small B cup with aprox 8cm areolas around each. The PO I am wanting to achieve is a full DD with aprox 4cm around each areola. I have been told that weight and depending on stitch types it can stretch out again so I may be limited on what size implant I can go. Could I achieve the desire I want 450cc silicone sub muscular implants with breast crease incision and areola reduction with permenant stitches?
Breast Aug & Areola Reduction
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Doctor Answers 8
Breast augmentation and areola reduction
Without an exam, I can not be sure what can be achieved for you. I do alot of areola reductions when indicated, but the exact final size sometimes is difficult to predict.
Areolar Reduction and Breast Augmentation
Thanks for your question. In the U.S. the FDA has placed some restrictions on breast augmentations using silicone implants. Specifically, they have stated that you must be at least 22 yrs. old. I am not sure where you are located (outside the US ?) so you may want to check this out with your plastic surgeon.
You mentioned that the size of your areola's are 8cm around. I am not sure if you are referring to the diameter or the circumference. If that is the diameter, then it should be of sufficient size to place the implant through. This would eliminate a second scar.
When doing an areolar reduction, using a permanant suture would help reduce widening of the scar by reducing tension on it. However, it may not be possible to be done at the same time as this may place too much tension with the size implants you desire and the additional post operative swelling. You may have to delay the reduction portion to allow for some laxity to develop.
As far as the size you are considering, it would be helpful for a full exam to get a better idea of your body frame and dimensions to better select the appropriate volume and shaped implant.
Make sure you discuss your questions with an experienced board-certified plastic surgeon to help guide and educate you in making the best safe and appropriate decisions for you.
Brian Joseph MD, FACS
Areolar reduction and breast augmentation
You've done some reading and thinking which is very good. Things you might consider:
1. Areolar reduction involves an incision therefore a scar around the areola. If you are having implants as well it is logical to place them in through the periareolar incision, it is unnecessary to have a second incision.
2. Areolar reduction, however it is done, and with whatever permanent purse string suture technique employed, often will not work all that well if implants are used at the same operation. This is because you are trying to do two opposing things at once - pull the skin around the nipples in with the reduction, and pull it out with the stretching and tension created by the augmentation, all at the same time. In the event that the areola re stretches out post op because of this it can be re done maybe 6 - 12 months later once the tension in the skin around the areola has lessened.
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Augmentation along with areolar reduction
You left out some important information, namely your height and weight. 450 cc implants are one thing in a person 5'8" and 140 pounds, and will have a different end look in someone 5' 105 pounds. Personally I caution my patients not to go too large, unless they don't mind a fake look. I agree that you could do the implants through the peri-areolar incision and that with a permanent purse string suture, the areola shouldn't stretch out. Technically, if you are only 18, you are not a candidate for silicone - don't shoot the messenger, blame the FDA. Best of luck.
Breast Aug. and areola reduction is legitimate combination
In order to control the areola size I would recommend a permanent purse string suture. The implants could be placed thorough this same incision site and not add a breast crease incision. Discuss this with your surgeon. It sounds like you are on target with your implant size and desired PO size. Make sure you try on implants and get a feel for the added size so you are comfortable with your choice.
Breast augmentation and areola reduction
If you are going to have an areola reduction ,the implants will be placed through the same incision.There is no need for an incision in the breast fold
It is important that several braided permanent sutures are used to prevent stretcching of the areola
Areola reduction at augmentation
If you are a size B and want a DD, that is a 3 cup size increase. If you are a size 32 or 34 bra then that corresponds to 300 cc's. If you are a size 36 or 38 bra then that corresponds to 600 cc's. Depending on how large you are, these size implants may or may not fit in the retro-pectoral position. The average size of the nipple should be about 4.2 cm and you certainly do need a reduction from 8 cm. I recommend you undergo circumareola approach that will reduce the nipples and allow the implant placement.
Best of Luck,
Gary Horndeski, M.D.
Permanent sutures for breast augmentation and areola reduction
You should be able to have a nice outcome with permanent sutures (mayve Gortex sutures). As to the size, it is difficult to make a recommendation on the size of the implant without an examination. I don't know if 450cc will help you achieve the desired size. You may require larger implants to get to a DD. Also, you may want to think about having the augmentation done through the areola since they are cutting there anyway. This would spare the "breast crease incision."
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