Should I have areola reduction on left side? Switching from saline to silicone. (photo)

I want to regain fullness and switch to silicone. I've had these 350cc saline unders (mod) for 15 years and have had 3 kids. My surgeon is leaning towards 450-500hp -my bdw is 13. I am trying to decide if I want to have the left areola reduced or not. seems like the risks may outweigh the benefits... But I'm also afraid that the extra 100-150cc may stretch it out even more. Ugh Any input would be great!! I'm 5'3 120lbs - currently wear a 34 C

Doctor Answers 8

Areolar Reduction on Left?

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That base width measurement sounds wide for person with a small frame like yourself. Upsizing is reasonable but 500 cc sounds like a bit much unless you wanted to be noticeably bigger. It also has the potential to further stretch your areola. You can reduce the size of your left areola but doing a Benelli or donut type breast lift. The downside is that it will a leave with a scar around your areola, so you trade one type of asymmetry for another. I don't think the size difference is so great that it would be worth trading for the scar. 

Areola reduction is low risk

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I would recommend that the implants be placed through an inframammary fold incision, then you could have the areola reduction done with low risk. There will not be perfect symmetry but it should be an improvement. There is a procedure that reduces the areola by removing skin around the base of the nipple rather than the outer edge of the areola, which may leave a less noticeable scar.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Should I have areola reduction on left side? Switching from saline to silicone

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Thank you for your question. Larger implants would stretch and enlarge both areolas. If you choose an aroela reduction, i would recommend you have both reduced to the same size.  Best wishes. 

Both or neither

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I would not have an areola reduction because you will be trading one asymmetry for another. Either have both or neither done.

Areola reduction

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hi and thank you for the question. AnAriola reduction is not a substantially risky procedure. Plastic Surgeons do this on a routine basis as part of  breast lifts, breast reductions, as well as procedures where we combine an augmentation and a lift. The areole reduction you would need for symmetry is quite small. There is little risk of you losing your nipple if the procedure is performed correctly. if you want to take a more conservative approach, you could do the implant exchange in the operating room, then do the areola reduction three months later in the office. This is a very straightforward and well tolerated procedure to do in an office setting. Good luck to you. Dr West

Justin West, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 30 reviews

Implant exchange

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hello and thank you for the question and the photo. Based on your size and goals,  a change to larger silicone gel implants is an excellent option. I would caution the following:1. avoid the nipple incision. silicone gel comes fully filled. it is much more difficult to insert a gel through a nipple vs a saline implant. Second, there is a higher risk of capsular contracture when using the nipple incision vs the inframammary2. avoid the left nipple. there is a very mild difference in size, but it's not worth the effort and risk. the scar will change the appearance of the nipple and only if you were willing to do BOTH nipples, i'd leave it alone. There are always risks to everything we do. From surgery to botox, there is no 100% safe procedure. So unless the benefit signficantly outweighs the risks, I always recommend taking the safe path. As always, best to be healthy, no smoking, and make sure any health concerns you have are managed by your primary care md. Best to you. 

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Areola lift

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I think you will look great when you change the implants and increase the size.  Your left areola may increase in size a little, but likely it will be proportionate to an increase in size of the right areola too.  Although your left areola is larger, it will also have some differences if you place a scar all the way around it, when you don't have a scar on the right.  My preference would be to leave it alone and see what happens after your implant exchange.  If you really don't like it afterwards, you can have the left areola made smaller.  In that scenario, it could even be done without the need for general anesthesia.  Best of luck!

Jonathan Heistein, MD
Fort Worth Plastic Surgeon
4.7 out of 5 stars 29 reviews

Should I have areola reduction on left side? Switching from saline to silicone.

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Thank you for the question and picture. Whether or not to undergo a areola reduction surgery at the same time as the revisionary breast surgery will depend mainly on the analysis you have already done. You will need to weigh your level of concern with the areola size and/or asymmetry versus potential risks/complications/downsides associated with the areola reduction surgery. Ask your plastic surgeon to show you examples of previous areola reduction patients;  this may help you make an informed decision.
 Best wishes for an outcome that you will be very pleased with.

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.