I Am Very Self Conscience About the Size of my Areolas, What Are My Options?

I am interested in a breast aug, but am worried about what my areolas with look like after. I am 23 years old 5'3, with no plans on having children anytime soon. I am about a full B cup, with my right breast slightly lower and pointing downward. I would like to know what my options. I am looking for a much rounded appearance, with a possible areola reduction. I attached a picture below as well. Thanks so much, Adrianna

Doctor Answers 15

Areolar Size, Prominence, and Breast Augmentation

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You have some mild breast asymmetry that involves volume, shape, nipple-areolar complex (NAC) position, and breast position on the chest wall. None of these are severe and can be considered within normal variants. The right breast looks slightly larger in size and the NAC is positioned a bit lower on the right breast. From the single photograph you provided, your breasts have an appearance that they are not quite fully mature – the breasts have a bit of a pointed / conical shape, and the NAC is a bit full / prominent. The areola is elevated / projects above the surface contour of the surrounding breast as a sort of mound; and this appears to be more prominent on the right, compared to the left.

So when you say you don’t like the size of your areolas, are you referring to the diameter or the prominence?

I do not think that your areolar diameter is excessive for the size of your breast. If you have breast augmentation, I don’t think it will change much and will still be appropriately sized. Areolar reduction does involve a circum-areolar scar that does eliminate the natural color transition between the areola and skin. Areolar reduction or lift could be delayed, and performed only if deemed necessary after your implants have settled into place.

The fullness and projection of your areolas will probably not be addressed with an areolar reduction, as the change in diameter will be small. The projection of the areolas will change following pregnancy and final breast maturation, when they should become flatter and the contour more level with the surrounding breast skin.

Breast augmentation may not fully change the shape of the breast either; rather than being completely rounded, your breasts may still have a slight pointed / conical shape.

The physical exam is an important part of being able to answer these questions more specifically. Be sure to discuss all your concerns with you physician, so you can understand the expectations of surgery. Best wishes.

Milwaukee Plastic Surgeon
4.9 out of 5 stars 36 reviews

Areola reduction

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The size of your areola can be reduced in conjunction with breast augmentation, however it would involve a scar that would go around the entire circumference of the areola. Judging from your photos, in my opinion, the extra scarring would not be worth it, but it is something you can decide for yourself.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

I Am Very Self Conscience About the Size of my Areolas, What Are My Options?

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This is a very personal issue as is your breasts asymmetry. Best to have in person evaluations with boarded PS's in your area. Thanks for the excellent posted photo. Shows breast asymmetry and areolar asymmetry. 

Areolar Size

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The areolas can be made small by making an incision around them and removing some of the extra areolar skin.  This technique can also be used to do a small lift on one side to make the nipple location more even with each other. Although absolute symmetry is impossible to achieve, significant differences can be made less noticable. 

In order to achieve a more rounded breast look, breast implants are needed and can be done through the same incision around the areolas or through a different approach.

Adam Hamawy, MD
Princeton Plastic Surgeon
4.8 out of 5 stars 57 reviews

Candidate for breast augmenation and lift

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Based on the photo you provided, you are a good candidate for breast augmentation. In order to achieve your goals and improve your assymetry, you may want to consider a limited breast lift (mastopexy). A limited breast lift would involve an incision around the areola, which would allow me to reduce the size of the areola. This areola reduction may also help with any “puffy” areola appearance. This procedure will result in a scar around the areola so you need to weigh the pros and cons. Breast implants provide more fullness and volume to achieve a rounded appearance. I recommend consulting with a board certified plastic surgeon to discuss the best and safest possible option for you. 

On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.

Get more than one opinion.

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Your areolas are normal. An augmentation could easily be done, but no matter how we reduce the size of the areolas, they may stretch out again. Even with a suture reduction technique, over the years, they can end up just as they are now, with a stretched out scar around them.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

The uneven areola

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Just as one breast is often slightly larger that the other, so too the areola and nipple position can be different left to right. When considering correction you have to understand the scar, and the possibility of relapse which can be common with 'around the nipple' areolar reduction and lift. Considering that your photo has a rather modest asymmetry you might want to put off any decision for a time and come back to it if it becomes a must do.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

You would benefit with areolar reduction and correction of asymmetry.

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You look like an ideal candidate for a simple "doughnut type" breast lift.  Your areolas are large and somewhat bulging, and as you say, the right one is lower.  These things can be corrected and you can get a rounded look.  The scar is a circle around the nipple, and it usually fades nicely.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Areolar size can be reduced

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You have a mildly constricted breast shape with dilation of the areola that accompany that shape. I would recommend a breast augmentation using a reasonably sized silicone implant in the sub-glandular plane through a peri-areolar approach, lower both infra-mammary fold to increase the vertical height of your breasts and do a 'donut mastopexy' to reduce areolar diameter using Gore-Tex interlocking suture technique. I think you'll have a nice result.

Minimize your scarring

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Every woman has some differences between the breasts.  The size of your areola is not excessively large compared to many women and certainly not enough to justify the scarring that would be required to reduce them.  Rarely does augmentation surgery cause the areola to increase in size.  My suggestion would be to go ahead with the augmentation but hold off on any additional scarring until you've had your family (or decided not to).  I would suggest that the implants are inserted through an incision in the Inframammary fold.

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.