Should I consider an areola reduction or breast implant? (photos)

I have very large areolas paired with small breasts (one being larger than the other). It would be nice to have my breasts slightly bigger, however my main concern has always been my areolas. My skin scars very easily and I'm worried that an areola reduction will leave scars that are so apparent it just isn't worth it. I've considered getting breast implants so that maybe the size of my breasts will pair better with the size of my areolas. What would be the best course of action?

Doctor Answers 13

Would you recommend an areolar reduction or breast augmentation or both?

Simply enlarging your breasts will not help improve the size ratio since your areolar are already enlarged and may actually get bigger with placement of implants.  To create better symmetry, I would place sub pectoral implants and then reduce the areolas and lift the breast tissue using a lollipop incision breast lift.  I hope this helps and wish you the very best!  Make sure and choose a Board Certified Plastic Surgeon who specializes in breast enhancement surgery.  

Denver Plastic Surgeon
4.9 out of 5 stars 42 reviews

Periareolar Breast Reduction

Thanks for your photo.I guess that your areaola size is now arround 5cm but it should be 4 cm.You will benefit from a periareolar reduction with implants which will be placed inframamarial.Please consult and discuss with a board certified plastic surgeon.Good luck.

Ozge Ergun, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 23 reviews

Areola reduction vs. implants

Hi c1997,   The proper procedure should be determined based on what you would like to achieve with the overall look of your breasts. If you want larger breasts, implants will help, but they will not make your nipples look more in proportion with the breasts. In fact, implants will make your nipples get larger and more out of proportion to the breast size.
If you decide that larger breasts are what you would like, you almost certainly would need some sort of lift, most likely a lollipop type. If you simply reduce the size of the areolas, along with placement of implants, the areolas will stretch over time and end up being bigger than they are now. The lollipop incision will take the tension off the nipples and give you a more youthful look. There are many scar treatments that can be applied, but you need to achieve the proper breast form first and then have your plastic surgeon help you with the various scar treatments available.Hope this helps.Best,Dr. Christine Rodgers

Christine Rodgers, MD
Denver Plastic Surgeon
4.9 out of 5 stars 89 reviews

Areola reduction and possible augmentation

Dear c1997,Your choice of procedures depends on your goals. You can make the areola smaller by performing a periareolar mastopexy where are a smaller circular incision is made within the areola and a larger circular incision is made around the outside of the areola. The skin between them is removed and then the larger  outer circle is sutured to the smaller inner circle, cinching in the skin.  There can be some puckering to the incision if the discrepancy in the sizes of the circles is large. Be sure you look closely at pictures  of the results obtained before going forward.   And implant can also be placed if you are interested in enlarging the size of your breasts. One of the downsides of doing these two procedures at the same time is that tension on the skin from enlarging the breasts can also affect the overall results of the scarring at the areola The size of the areola can also expand over time  do you to the stretching from the implant. If given the choice I generally prefer to use a vertical mastopexy when patient's desire a much smaller areola size. This  scar has a vertical limb or a lollipop design. I find that this provides a consistent areola size with an improved quality of scar and generally more attractive shape to the breast. This is just my opinion and I do perform periareolar mastopexy's when I need to, but prefer the aesthetic results from using a vertical technique.Best of luck,

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Areola reduction or breast implant?

You should do both. Your areolae are large and somewhat tuberous. A peri areolar mastopexy would help reduce, flatten and lift the nipples. Implants would give you better proportion and shape.The scars around the areolea generally heal quite well. There have been many advances made in scar treatment recently. Embrace has worked well to minimize scars. Selecting a good plastic surgeon involves many choices. RealSelf is a good place to startbut I would do much more research. First you want to make sure you are selecting  a surgeon board certified by The American Board of Plastic Surgery. Any doctor can call themselves a "cosmetic surgeon" and most
will be board certified in something, just not plastic surgery. I would look for someone who is a member of the American Society for Aesthetic Plastic Surgery (ASAPS). This goes a step beyond ASPS as member surgeons must specialize in cosmetic plastic surgery and be recommended by their peers. You should also only consider plastic surgeons who have local hospital privileges and who operate in accredited facilities, not in their office. Also make sure they only use board certified anesthesiologists. I would then look at reviews on RealSelf and Google. Also look at their website to see if they have many post op photos you like. Schedule several consultations and see which doctor and staff seems to be a fit for you. Ask to talk with previous patients who
have had the surgery you are considering. Anyone good will have a list of them.

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 79 reviews

Should I consider an areola reduction or breast implant?

Thank you for your question.  In this case, you can have placement of breast implants to increase breast size, upper pole fullness and improve cleavage and have a circum-areolar (donut) mastopexy to help reduce the size of the areola.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Augmentation would be your best choice

Thank you for your question. I understand your concern about the arreolas scarring, but as with any surgery, scarring is completely normal. I think you would benefit greatly from an augmentation to achieve the full look you desire. Although, should you choose to have only the augmentation, the arreolas could expand to a larger size. Please consult with a board certified plastic surgeon. Best of luck!

Mary Jo Wright, MD
El Paso Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast Augmentation or Areola Reduction or Both

Your concerns about the quality of an areola scar are important in considering the best option for you.Based on your photo and questions, it's reasonable to consider areola reduction or peri-areolar mastopexy, as well as breast augmentation - either alone or in combination with peri-areolar approach to reduce the areola. Those considerations include not only the placement and quality of the scars, but also the volume/size breast you would like and specific shaping you prefer for your results. Discussion should include what an acceptable and likely scar would look like and what can be done to optimize the quality of the scar.To best help you determine the best option, an examination is necessary. Choose a Board Certified Plastic Surgeon who listens closely to your concerns and who adequately explains the anticipated results or trade-offs of these different options.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.6 out of 5 stars 39 reviews

Breast surgery

from looking at your pictures you seem to have a bit of breast ptosis/sagging as well as asymmetric and deflated breasts.  I recommend that you have a breast augmentation through a periareolar incision and have the areolas reduced in size at the same.  This will give you a fuller and more aesthetically pleasing breast as well as lift your breast position to a more aesthetically pleasing a position. There are methods to improve the scarring and I would not be worried about the scarring as much as I would be the shape of your breasts.

Payman Danielpour, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 37 reviews

Should I consider an areola reduction or breast implant?

I would recommend an augmentation first, since you are concerned about scarring. If you think that your areola are still disproportionate after the implants have settled, then you could proceed with an areolar reduction. Good luck!

Keith Hodge, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 27 reviews

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.