Unhappy with my breast augmentation and areola reduction, what can be done to further reduce the size of my areola? (photos)

Dear plasticsRN,
it is hard to tell for sure without an examination. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

As you have already undergone a revision I encourage you to meet with another board certified plastic surgeon near you for a consultation. Discuss your goals for surgery and listen to varying opinions. It seems more time is needed to determine the best approach to get the result you want versus more surgery too soon and end up disappointed again. You can discuss options such as implant size and placement as well as options for areola reduction.

I would not suggest going any larger with your implants because they will sag and stretch your areolae over time. The areolae are the most stretchy part of your breast skin. When the breast is expanded, as with an augmentation, the areolae will expand. Your best chance to have smaller, but not small, areolae is to use permanent suture like Gortex for better holding power. Not all surgeons will use this because it carries a higher risk of needing to be removed over time.

Based on your post of photos, you would need a third revision to increase the size of the implants by at least 150 cc to 250 cc. You can leave it in the same location. As for area nipple complex reductions, this can be done for a third time using a technique of a per string suture to decrease the diameter of the nipple complex. Fee eight to $10,000. Best of virtual consult with.

To make a quality assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you’ve had more than one operation than you should ideally include before and after pictures for each of the previous procedures.
If you don’t have before, and after pictures and ask your surgeon to forward the pictures they took.It’s a limit to how much skin can properly be removed with the procedure you had.
This is true whether you’re having only an aerial reduction or also with a lift.
To reduce the size of the areola sufficiently, you may have needed a lollipop type breast lift, even if it didn’t lift the breast all that much.
That procedure takes the pressure off the circular incision.
It looks to me like you may have had slightly tubular shaved breast that were small diameter to start with.
I can’t emphasize enough, the importance of always, including proper before and after pictures.
Personally, I prefer to put the implants under the picture muscle and find that procedure has a lot of advantages.
We generally try not to change things around too much after the first procedure has been designed.
Converting to a sub muscular implants placement is an option, but it would’ve been better to do that During the first procedure. Likewise, doing the Ariola reduction with a lollipop scar may have also been better as an initial choice rather than as a subsequent third operation.
Your situation is fairly complex and I think it is beyond giving quality assessment based unlimited information.
If you want a second opinion, consultation and schedule those as proper in person, second opinion, consultations with other plastic surgeons in your community.
For second opinion consultations come prepared bring with you a complete set of proper before and after pictures and operative reports of your previous procedures.
These are all part of your medical record and are available from your current provider if you request them.
Best,
Mats Hagstrom MD