Areola reduction - how does a crescent approach work?

Question

Hello: I have had three consults for a areola reduction and I have been left with a few questions. For reference, my areolas are about 2.5 inches and I am hoping more for the 1.5-1.7 range (full c breasts) One doctor suggested a crescent approach, but I am confused how that will actually deacrease the size of my areolas? Can someone explain? Real self doctors in other's posts mentioned a permanent stitch, but all three doctors I went to advised against it because of the risk of it ejecting. What is the risk with that? I originally booked the procedure with the doctor who suggested the crescent, but now I'm thinking about canceling. To be honest, I am very frustrated with all the different information floating around.

Daniel Barrett, MD · Answer

Dear Pklovesbooks,

generally speaking, crescent approach can be a good option for areola reduction. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

It can be difficult to choose the right provider and the right procedure when you have conflicting information.  It is important to do your research.  Be sure you are selecting a board certified plastic surgeon.  Review websites which often include credentials and before/after photos.  Meet in person, ask questions, and then go with your gut.  The crescent approach provides a conservative lift but may not be the correct approach if your main goal is to downsize the areola.  I've included a video that I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

This can be a tricky procedure with potential future problems. 
There are a number of variables that can impact the outcome. 
One of them is the color of the skin, the color of the areola, and if the transition between normal skin and areola skin is clearly demarcated. Some women have a splotchy or gradual change in skin color from breast to areola. 
There is increased risk with future problems if a surgeon attempts a big reduction. 
The most common problem is widening of the scar and future stretching of the areola. i’m going to assume that the surgeon who’s doing a crescent approach is considering adding a partial lift. You should definitely know for sure what they meant before having surgery. 
Ask surgeons to show you as many long-term before and after pictures as possible.
Ask surgeons how often they’ve had to do revisions for these procedures. 
Using a permanent suture is more likely to minimize the chance of the scar or areola stretching. If the suture gets contaminated, it usually needs to be removed. Removing a contaminated suture as long as it’s not right after surgery it’s not that big of a deal. Absorbable sutures can get contaminated as well.
Trying to do to much with this procedure is probably the most likely reason patients are either unhappy with their outcome or end up needing revision surgery.
The overall patient satisfaction for an areola reduction by itself (no breast lift or reduction) is not all that high in my opinion. It’s a better procedure if done in conjunction with a breast lift.
It has a tendency to make the breast look a little flat as well. 
My best recommendation is to vet providers carefully based on their before and after picture portfolio.
Without pictures, we can’t begin to make an assessment.
I’m not saying you shouldn’t have the procedure, but be forewarned that a some patients are left with some regret.
Good luck,
Mats Hagstrom MD

Areola reduction - how does a crescent approach work?

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