Can I have just an areola reduction? (Photo)

Question

I spoke with only one plastic surgeon who told me the areola reduction alone would be impossible for my left breast (the size of the areola is 2.7cm from the edge to the nipple) because there would be a lot of pleating, but for the right it would work (2cm), so he suggested a lollipop scar on the left as well as fat grafting for the right. I was hoping I could get away with just an areola reduction, I like my breasts when the areola is shrunk. Is it doable? Shall I consult other specialists?

Wayne I. Yamahata, MD · Answer

I personally would not recommend any surgery. With an areolar reduction you are trading scars and potential flatting of the breasts for a smaller areolar diameter. I don't think your current areolar diameters are unattractive, so I don't feel that the benefits warrant the risks.

Leland Deane, MD, FACS · Answer

Be careful. I see a breast shape that is very nice, together with a small size. There areolar size may be a little large relative to the overall breast size but, aesthetically, I wouldn't reduce it. The costs are too great. Even with perfect scarring, a peri-areolar 'reduction' can flatten an otherwise nice shape. Any reduction that would be done, in addition, would be conservative, so is it worth it? I think not.

Daniel Barrett, MD · Answer

Dear Compassionate767700,
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

Andrew T. Cohen, MD, FACS · Answer

You can certainly do an areola reduction alone or with implants. I would suggest a small gel implant (200 cc or smaller) and a donut or Benelli mastopexy . This will give you volume and make the areola a nice size for you.

Best of luck. Look for a board certified plastic surgeon.

Best of luck.   Look for a board certified plastic surgeon.

Camille Cash, MD · Answer

There is a limit to the amount that an areola can be reduced without causing other issues, including pleating.  It's important to note that the areola can stretch over time as well.  The size of your areola does not appear to be excessively large.  Unless you are needing a lift, which you do not currently, and are undergoing further incisions you may want to consider augmentation only.

Mats Hagstrom, MD (license on probation) · Answer

I think with the plastic surgeon told you during the consultation is spot on.
Attempting to do too much reduction leads to problematic outcomes with widening of scar. 
My recommendation would be exactly what you were told.
My only caveat is to point out that the number of plastic surgeons have truly mastered liposuction and fat transfer is pretty small.
The outcomes for both Liposuction and fat grafting varies dramatically, depending who you go to.
Doing these procedures, well on a consistent basis, turns out to be a bit more difficult than most people realize.
 Before considering having Liposuction and fat transfer, I recommend patient vet providers thoroughly and have multiple consultations.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own.
 Recognize the breast fat transfer is always to procedures done at the same time.
It always involves Liposuction to harvest the fat.
Too many times patients are left disfigured from the fat harvesting aspect of the procedure when in reality, Liposuction should be part of the benefit of having fat transfer.
An experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patients.
When reviewing fat, transfer results, always confirm the timeframe of when the after pictures were taken in relationship to the date of surgery.
Early fat transfer results can look very impressive, but do not in anyway represent final long-term outcomes.
 Never assume that after pictures are final long-term results without getting confirmation.
Fat transfer results start approaching final long-term outcomes by 3 to 6 months.
Photos taken less than three months from the date of the procedure are not representative.
Likewise, ask providers to show you the Liposuction results of all the before and after pictures they show you.
Asked them to point out exactly what areas were treated and what areas were not treated and look carefully at transition zones between treated and untreated areas.
 Mastering liposuction and fat transfer takes a total lifetime, commitment and providers who don’t have the skill and experience can easily leave people permanently disfigured.
I recommend patients have multiple in person, consultations before selecting a provider for this.
The consistency of areola reduction is most likely far better than that of liposuction and breast fat transfer.
All plastic surgery procedures are going to have variation in regards to provider selection.
Some providers are simply more experienced and more talented than others.
Being board-certified in plastic surgery with years of experience in an overall good reputation does not mean a plastic surgeon has mastered any one single procedure. There’s no correct number of consultations needed to find the best provider.
Look for plastic surgeons, who have a proven track record with liposuction and fat transfer, and who seem to do these procedures either exclusively or this represents a large percentage of their caseload.
The more consultations, you scheduled the more likely you are to find the better provider.
You could certainly move forward and have the areola reduction without fat transfer.
Implants are a far better and more consistent way of augmenting the breast if you’re looking for breast augmentation.
For those seriously considering Liposuction and fat transfer, I recommend considering having five or more consultations before selecting a provider.
I cannot emphasize enough the importance of provider selection and taking an active role in vetting plastic surgeons and not assuming that people know what they’re doing without confirmation.
The time to be critical of plastic surgeons is before you schedule the procedure.
Best,
Mats Hagstrom, MD

Can I have just an areola reduction? (Photo)

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