Breast Augmentation and Areola Reduction?

Hi :) I am going to be getting breast augmentation done soon. I am currently a lovely deflated C thanks to my two lovely breast fed children. What I want to know is when I get my implants can the doctor do the areola reduction at the same time? Also how do they do the incision for that. Will I have to have the scar that runs from my areola to under my breast? Or do they just cut the areola off pretty much? :/ also what is the average price for areola reduction? Thank you all!!!!

Doctor Answers 18

Areola reduction and breast augmentation

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There seem to be some misconceptions and possibly some definitional problems here. The nipple-areola is a completely separate issue surgically from breast augmentation, particularly if (what I view) the old-fashioned peri-areolar incision is not used. 

Breast augmentation with an implant is just a pillow behind your breast. It does not stretch the areola or make it bigger but may fill it out if it is collapsed and make it appear to be bigger. A large nipple or areola can also look a bit smaller if the breast is filled out and looks bigger around it. 

Areolar reduction is not a substitute for a breast lift and as was pointed out, the attempt to reduce the areola while placing a large implant behind the breast works against control of the size of the areola and the tension on the scar around the areola. 

If you do not need a lift of the breast along with the augmentation, I would advise doing the augmentation without the areolar reduction and see how you feel about it after the augmentation has settled. You can always reduce the areola (or nipple) under local anesthesia as a separate procedure later on if you feel you still need it. 

Boulder Plastic Surgeon

Areola reduction

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Areola reduction can be done a few different ways.  One way is to cut out a donut of areolar skin which results in a scar going all the way around the areola.  The other way is to do it as part of a vertical lift, which leaves a lollipop scar.  Which one is better for you will depend on a few different factors and is hard to tell without photos.   Personally, I prefer the lollipop scar because it prevents the areola from stretching out gain.  Good luck!

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 28 reviews

The areolae may be reduced and implants inserted through the same incision.

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Breast implants make your areolae about one centimeter wider, which of course is not what you want.  So, yes, a circumferential areolar reduction would be appropriate.  The same incision can be used to insert your breast implants, so your only scar will be the circular one around your new, reduced areolae.  That vertical scar you mentioned is needed if you are quite saggy and need a breast lift.  The cost of an areola reduction is much less if you have it simultaneous with your breast augmentation.  In my practice, we add $1500 to the price. I've attached a link to the breast lift part of my website so you can see what areola reduction look like (just ignore the vertical scars).

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 61 reviews

Areola reshaping is part of a breast lift or alone as an areolaplasty

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Thank you for the question.  If you are undergoing a breast lift as well as an augmentation your plastic surgeon will be able to reshape your areola size as part of the breast lift procedure.  If an augmentation is performed alone, an areolaplasty can be performed at the same time to reshape the areola.  The incision for reshaping the areola goes around the areola.  It is sometimes called a purse-string areolaplasty.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 171 reviews

Can be done at the same time

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Both procedures can be performed at the same time, and the type of incisions you'll have depends on the extent of correction required. You may only need to have a periareolar incision.

Breast Augmentation and Areolar Reduction

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You can do an areolar reduction at the same time as your breast augmentation. If you have only slight sagging, the incision would go all the way around the areola. If you have more sagging, it would be better corrected with an incision that also goes from the areola to the bottom of the breast (lollipop shaped). The areola is not cut off in either case. Really it depends where your areola sits compared to the fold underneath the breast how much lift you need.

Breast augmentation and areola reduction

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Yes both can be done at the same time. This procedure the peri areolar mastopexy is reserved for patients who need lesser degrees of lifting.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Concerns about Breast Augmentation/Lifting?

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As you can imagine, without direct examination or viewing pictures, it is not possible to give you precise advice.  Hopefully, some general information about breast lifting/augmentation may be helpful to you. Generally speaking, the type of breast lift that a patient would benefit from will depend on the degree of breast ptosis (“drooping").   In other words, the more “sagging” a specific patient's breasts demonstrate, the more breast lifting is necessary. As you may know, all forms of breast lifting involves some amount of skin excision.   The skin excision serves to “tighten up” the breast skin envelope. How much skin needs to be removed will depend on each specific patient's situation. In other words, some patients require more “lifting”  and have the need for additional incisions. Generally, these incisions range from around the areola, vertical breast incisions, and transverse incisions (“anchor”). Most patients (If properly selected and who are doing the operations and the right time of their lives) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do and the field of plastic surgery. I hope this helps.

Areolar reduction with breast augmentation

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You can have a circumferential augment, such that the incision is used for both procedures. However, since this remove that extra "donut", as Dr. Rock has observed, careful attention must be given to the implant size to insure that there is not excess tension on the incision site.

Breast augmentation and lift

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Without at least seeing photos and preferably performing an exam, it is difficult to say what would be best for you. If you do not have significant sagging, and implant with /without a circumareola lift could be beneficial.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.