Large Areolas and Droopy Nipples. What Breast Surgery Do I Need?

I am uncomfortable & embarrassed of my breasts b/c of my big aereolas, and I would like my nipples to be higher up. Im wondering if I need just aerola reduction, or if I need a lift and/or implant too. What do you think? The first 2 photos are me, and the last 2 photos are what I want my breats to look like (natural). What do I need to do to get to my goal breasts? Thank you!!

Doctor Answers 32

Breast Lift or Not?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is common to compare ourselves to others, as you are doing.

Your two photos do not suggest that you are as "bad" as you feel.

I would advise giving surgery plenty of thought as any areolar or other type of breast lift will create scars that you may end up being more unhappy with.

Miami Plastic Surgeon

Large Areolas

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Hanna G,

I will begin by telling you that what you perceive as a source of embarrassment - ie. your areola, are not that unusual or large.  I would suggest you think long and hard before pursuing surgery, as the scars from any suggested surgeries may result in poorer cosmesis.

Nonetheless, if you really wanted to have surgery, an areolar reduction with a peri-areolar mastopexy technique could be used.  The downside of this technique is that it may make your breast appear more boxy.  In addition, the scar around your areola may widen with time.  

Speak with one or two experienced plastic surgeons in your area and go over the pros and cons of all proposed procedures.  Think about it long and hard - I think your breasts are better off without any intervention at this time.

Warmest Regards,

Asif Pirani, MD, FRCS(C)

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Smaller areolas

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
From what you write in your note the size you want to be is similar to where you are now so simply doing a donut mastopexy to make your arelar complexes smaller is all that may be needed.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

Breast Lift with Areolar Reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello and thank you for the question.

In review of your photographs and given consideration of your desired results, I would offer you a vertical mastopexy ( lolli-pop scar breast lift). This will afford you both a breast lift for the moderate ptosis, which your breasts have as well an areolar reduction to a size that is better proportioned to your breasts. I recommend you consult with a Board Certified Plastic Surgeon who has ample experience in breast rejuvenation surgery.

Best of luck,

Glenn Vallecillos, M.D., F.A.C.S.

Glenn Vallecillos, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

Areola reduction, breast lift, or augmentation?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
If you are happy with your breast size, there is no need to perform an augmentation with breast implants. Because you have droopy or sagging breast, I recommend a breast lift or mastopexy. I don't think a periareolar lift would be sufficient. A mastopexy would reduce your areolas at the same time.

Good mastopexy candidate

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question and your photos.  The appropriate operation to correct the issues here is likely a mastopexy (breast lift), with or without the addition of an implant.  Breast lift surgery will reduce the size of the areola, as well as raise the level of the breast mound on the chest wall.  A well-done mastopexy results in a high, round, but natural-looking breast.  It can be combined with the placement of an implant if you desire additional volume, as well as a higher breast with a smaller areola.

Areola reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It looks like your breasts are relatively proportionate and aren't so droopy. An areola reduction can be performed. You may also need a breast lift if you want your breasts to be perkier, but I can't make that decision based on your photos only.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 25 reviews

All depends on you end goal

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the question.  Breast lift would be able to reduce your areola and reduce your breast size by removing excess skin.  It would be hard to tell if your desired look is possible without implants basing on photos alone.  It's good to remember that surgeons do what they can for you to achieve your desired end results.  Best to visit a board-certified plastic surgeon.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 122 reviews

Surgery for areolar reduction with lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. Large areolas and nipples can be surgically reduced to a desired size. There would be an incision placed around the perimeter of the areola. As in any surgical procedure, there are trade-offs. In your case, you have to visualize a perimeter incision vs smaller areolar diameters. I would describe your areolar diameters from your photos as only mildly wide, meaning it still only covers a small portion of the breast versus in some women where it covers over half the breast. I would visit with a board certified plastic surgeon to discuss your options in more detail.

Breast lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello, and thank you for this question. Based on your pictures I feel a minor lifting procedure may be in order. You could certainly obtain some improvement with a doughnut-type mastopexy. If you would like to have more cleavage and more fullness smaller implants may need to be placed. That would also depend on your native skin tone and skin elasticity which could be  evaluated in a  formal evaluation and physical examination with a qualified plastic surgeon.

John J. O`Brien, Jr., MD
Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 31 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.