To What Extent Can my Areolas be Reduced?

Question

I have very large areolas. My right areola is slightly larger, although my breasts are approximately the same size. I'm 23, 5'2'', weigh 120 lbs, never been pregnant and don't intend to in the next several years. I am interested in getting just an areola reduction (no other procedures) and I would like them to be reduced as much as is possible without any serious risks of side effects. How intricate would such a procedure be and what is the maximum size reduction I can expect?

Jason Hess, MD · Answer

Posting pictures here is the best way to glean some useful info.  So thanks for posting them.  Areolar reduction is common to breast surgery and is part of a procedure known as a circumareolar lift.  A doughnut of skin is excised from around the areola and the skin surround it is re approximated with sutures.  I would guess that your current areolas measure at least 8  cm in diameter when relaxed.  The common reduction is down to 3.8 or 4.2 cm because this is the circumference of an instrument known as a "cookie cutter".  This is a stainless steal ring that marks the skin to be excised.  I would recommend a diameter of about 3.8 cm.  You could go smaller, but the smaller you desire, the more skin bunching around the nipple you could expect.  The outer diameter of skin is larger than the inner when a doughnut of skin is excised.  I hope this makes sense. 

	You don't need any implants or additional procedures. Without these additional procedures, your procedure could be done under local rather than general.  Good luck.  Hope this helps.

Richard A. Mouchantat, MD, FACS · Answer

Thank you for the question. Your areolas can be reduced in size to a more ideal size. This may also improve the overall shape of your breast. There would be surgical scars which are usually very acceptable. Consult with a board certified plastic surgeon to get a full consult and good luck.

David Stoker, MD · Answer

You are a great candidate for an areola reduction using a breast lift technique that results in a lollipop-shaped scar.

Camille Cash, MD · Answer

From the submitted photos the recommended procedure would be a breast lift.  The excess areola tissue would be removed and the nipple position lifted.  The areola result would be about 4cm in diameter.  I encourage you to begin by visiting with a board certified plastic surgeon near you to learn more about the procedure and your options including risks and benefits.

Tom J. Pousti, MD · Answer

Yes, you may be a good candidate for areola reduction. Fortunately, this is a procedure that can often be done under local or general anesthesia.

	You are wise to consider the scar that will result, around the  areola. The appearance of the scar may range from a fine line to a wide/thick/raise scar (that may require scar revision surgery).

	You should also consider  other unfavorable sequelae resulting from this procedure. This may include asymmetric areola, loss or change of sensation, wound healing problems (possibly suture related), recurrence of the &ldquo;spreading of the areola&rdquo;, hypo or hyperpigmentation around the incision line, and potential changing/flattening of the breasts' profiles.

	The &ldquo;maximum&rdquo; reduction possible will need to be determined on physical examination. Too much of a reduction will result in tension upon the closure line and potential problems afterwards.

	 

	Please make sure you're working with a well experienced/board-certified plastic surgeon.

	Best wishes.

James Nachbar, MD · Answer

You can definitely have surgery to reduce the diameter of the areola.  The main risks are the aesthetic ones: how much improvement will you get, will the areola stretch out again, and how bad will the scars be.

	The obvious solution is the circumareolar mastopexy, often called the donut mastopexy.  The main problem with this procedure is that it can be difficult to keep the areola from stretching out again, and it does not provide as much improvement in the extra skin of the breast as the more extensive mastopexies.  However, it does allow less extensive scars, and is less likely to disrupt the breast tissue and breast feeding in the future.

	For a circumareolar mastopexy, your surgeon will usually place a special permanent suture around the areola to reduce the chance of it stretching out again, but that does not always work, and if it breaks at some point in the future (usually on one side), one of the areolae could wind up being a lot bigger than the other.

Karen M. Horton, MD · Answer

It is possible to perform surgery with the express goal of reducing the areolas.  However, all surgery creates scars, and in this particular instance, the appropriate procedure is necessary to achieve your desired results.

	I would be extremely careful to seek out a Board Certified Plastic Surgeon with extensive experience in all types of breast surgery, and revision surgeries.

	In order to properly reduce the areola diameter and achieve a long-lasting result, a full mastopexy is required.  This will create scars, and will not only reduce the areola size, but will reshape your breast tissue and reduce the skin envelope of the breast.

	Simply trying to remove areolar skin without doing the steps above risks stretching of scars around your areolae and a result that is very similar to your preoperative appearance.

	Best of luck!

	Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

Peter E. Johnson, MD · Answer

Nipple reduction is sometimes the only goal of breast rejuvenation, and very often a part of a breast lift or reduction. The size of the areola can be determined by breast size, chest size, and overall aesthetics. One size does not fit all, though a range of about 3.5 to 5.5 cm. is a working number. Side effects for areolar reduction are few, though the scar can be problem for some.

	Best of luck,

	peterejohnsonmd

To What Extent Can my Areolas be Reduced?

Answers (8)