Breast augmentation through periareolar

Hello I've been thinking of getting silicone implants and have visited 3 cosmetic surgeons so far and all of them had different opnions, so i am kind confused. I want to have it done though periareolar because the doctor will be able to make my areola a little bit smaller that way... I dont like my areola sizes...I think something a little bit smaller would look better on me since I am 118 pounds and a size 2. MY GOAL is FULL C/SMALL D CUPSIZE, SMALLER AREOLAS AND NATURAL LOOKING. Thank you so much!

Doctor Answers 13

Breast Implants via Periareolar (Nipple) Incision

Hi mimizinha79,

The periareolar incision is one of the two most commonly used incisions and it is, in fact, a very good one.  Whether or not it can be used (aside from whether or not you want it used) depends on the size of the areola and the size of the implant being inserted.  A saline implant can almost always be inserted via the periareolar approach (technically an infra-areolar incision since the incision is made around the bottom portion of the areola rather than all the way around it).  That's because the implant is inserted empty and filled up once it's inside.  The silicone gel implant come pre-filled and so a larger incision is required for the same size silicone gel implant when compared with a saline implant.  There's a video on my site ( that discusses this in greater detail.

Furthermore, if you're concerned about how large your areola is then it's even more likely that you can use the areola as an access point.  So, depending on how large your areolas are and what size implants you're getting, you're that much more likely to be able to do it that way.

The areolar reduction, though, risks complicating things a bit.  Of course, it can be done.  In making the areola smaller a suture (stitch) would be placed around the areola in order to keep it from stretching out again; at least, that's the intent.  It doesn't always work that way and, in fact, the areola may stretch out to nearly its original size.

Finally, the disadvantage of doing the areola reduction at the same time that you're having implants inserted is that you're setting up a struggle between two forces: one procedure is pulling the areola into a smaller position and trying to keep it there, the other (the implants) is pushing outward and forcing the areola into a larger diameter (the areola, along with all portions of the breast, typically gets larger after a breast augmentation).  So, it may not actually be such a good idea to combine these procedures, even though your reasons for wanting to do so are understandable.

I hope that this helps, and good luck,

Dr. E

New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Periareolar Breast Implant Incision Considerations

An exam and measurements would be required to give a specific opinion for you. Here is some helpful information: All breast augmentation incisions have their pros and cons. If you do not have a small areola then a periareolar approach is reasonable and the scar is more camouflaged. However you should be aware that there is a higher risk of capsular contracture and not being able to breast feed with this approach. A transaxillary approach also has a higher risk of capsular contracture and has no breast scars. An inframammary approach would probably be the safest with least risk of complications with the scar tucked beneath the breast to hide it. Hispanics/Asian/Mediterranean, and African American populations have more of a tendency for raised scars/keloids.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Periareolar breast augmentation

Breast augmentation through a periareolar incision is a very common approach.  There is a slightly higher risk of capsular contracture (scar tissue) through this approach however I personally like this incision.  You can also decrease your areolar diameter as well.

The implant should be located subpectorally (under the muscle) regardless of the incision.

Discuss this in more detail with your board certified plastic surgeon.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 reviews

Silcone through periareolar

This is perfectly ok if your arela is big enough.Silicone is the best and will give you,in my opinion, a softer and more natural result.the less breast tissue you have the more important it is to get silicone.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 64 reviews

Smaller areola

The periareolar incision is a very common approach for breast augmentation. A complete circle incision would be needed to reduce the size of the areolae.  A submuscular placement of a silicone implant is performed through this incision.

If the areola incision is too small,  a Keller funnel can be used to place the implant in the submuscular pocket. So any size silicone implant can be placed through the incision. 

Andrew Turk, MD
Naples Plastic Surgeon
4.8 out of 5 stars 31 reviews

Periareolar Approach

With large areola, your surgeon should be able to perform an augmentation with a silicone implant and reduce the size of your areola. Understand that their will be an incision that runs completely around the areola and this will be somewhat more noticeable than just an inferior periareolar incision. 

Marc Schneider, MD
Fort Myers Plastic Surgeon
4.5 out of 5 stars 25 reviews

Periareolar insertion of silicone gel implants along with areola reductions

Because your areolas are larger than you desire and want them to be reduced, placing the implants through the lower portion of the incision would be quite prudent in most situations. However, if your areolas are actually not of a size that would allow a silicone gel implant to be inserted then another approach for insertion would have to be considered.

Were the physicians that you saw reputable board certified plastic surgeons? This is very important though it still doesn't guarantee a result. 

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Peri-areolar breast augmentation with lift

The problem with performing a strict periareolar lift and augmentation is that all of the tension on your incision line will be transferred to your areola. This will compromise the healing of your surgical incision line. Instead, you should consider a vertical mastopexy lift with augmentation. This will provide you the ability to make a smaller areola yet transfer the tension down on your breast and not around the areola.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 68 reviews

Areolar size in breast augmentation

If you want your areolas to be smaller in diameter, going through the armpit or fold is not going to change that.  The only way to reduce your areola is to remove some of the outer circumference. This means an incision and scar that goes all the way around the areola and yes, the implants can be placed through that approach. Ask to see photos of patients who had areoals made smaller.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Areola reduction and augmentation

If your areola are large, the implants can certainly be placed through this approach and a reduction of the areola can be done at the same time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.