What are My Options for Reducing the Areaolas and Adding Good Shape and Larger Size to my Breasts? (photo)?

I've hated my breasts forever! Id really like to change this before I start grad school and get too busy. What I really want is just to have a smaller normal areola and for my breasts to have a good shape & a slightly bigger size & generally point the same way. What is my best option? Will I need multiple surgeries or have bad scars?

Doctor Answers 15

Areola reduction and breast implants

Thank you for your question and the photograph.

To accomplish your goals, I recommend a circumareolar breast lift (incision all the way around the nipple) with placement of breast implants.

This will decrease the size of the areola, lift the breast, and increase the size of the breast mound.

Discuss this specifically with you plastic surgeon.

Your main risk for scarring is a widened areola scar but this can be prevented by placing a pursestring suture around each areola.

Best of Luck.

Nashville Plastic Surgeon
5.0 out of 5 stars 181 reviews

Options for re-shaping the Breasts and Reducing the Areolas

Hi there-

Without a consultation and examination, it would be irresponsible for me to make a recommendation to you... and also would be unfair to the surgeon you eventually choose if their recommendation differs slightly.

Generally speaking, I would say you have several excellent options, but you really should see a good surgeon to understand what they think works best IN THEIR HANDS.

Those of us on this site can only tell you what WE would do, and we are basing this on ONE photo. There are too many assumptions being made for these recommendations to be reasonable:

  1. We have to assume that we can tell what the qualities of your skin are based on the photo
  2. We have to assume we know what your desired appearance is based on your limited description
  3. You have to assume that what we think looks good is what you will also think looks good
  4. You have to assume that the outcome of any given procedure is the same, regardless of which of us does it

NONE of these assumptions are okay....

The best advice I can give you is to spend your time and energy finding a surgeon Certified by The American Board of Plastic Surgery who you like and feel you can trust. Visit for a consultation and discuss your options. Look at lots of photos of the options you are offered. 

If you put yourself in the right hands, the other details will take care of themselves.


Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Breast Augmentation and Lift - Reducing Areolar Size

It is often a question of balancing your concerns (small size, large areolas) with what's involved in addressing them.  It's hard to say for sure from your photos alone but it appears that I would recommend a lift with implants.  It looks like your skin has relatively poor elasticity (nothing personal, of course) and, combined with large areolas, it would make sense to reduce the areolas and tighten the skin.  That's a lift.  You also want increased volume; that's the implants.  I would probably recommend a circumvertical lift (a lollipop scar) though you may need a small horizontal limb across the bottom.  Combined with implants, I think this would give you the best shape.  Whether or not you're willing to go through what's involved (time, costs, scars, risks) is what you have to talk about with your plastic surgeon.  If there is any question, you should go for several consults.  This is an important decision, and the time to do your research is before you undergo any surgery.

I hope that this helps, and good luck,
Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Reducing aerola size

Based on your photographs, performing either a periareolar lift with implants or full mastopexy with implants would achieve your goals of reducing the areola size, improving the breast shape and increasing your breast size. Find a board certified plastic surgeon in your area, and he or she should explain your options fully.

Donna Rich, MD
Houston Plastic Surgeon
4.5 out of 5 stars 33 reviews

Breast lift and fat grafting

You have fair amount of breast tissue and the lift will help with the areola size. The options for the adding volume are implants or fat grafting. I prefer fat grafting in your case because of deficiency of the upper pole. The other advantage of the fat grafting is using own tissue . If you decide to have implants ,I would do it in two stages. You can check my web site for examples of fat grafting and lift.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Breast Lift

From your photos, I believe that your best option would be to have an augmentation and breast lift combination procedure.  I favor either a circumvertical or short T-scar lift.  A periareolar lift, in my opinion, works well for decreasing the areolar size, but will not lift the breast or areola position much.  The periareolar lifts also have a tendency for areolar widening especially if too much skin removal is done.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 72 reviews

Mastopexy + Augment to fill and lift!

The best option for you judging from your photos is a combination breast augmentation and lift which can be accomplished in a single operation! The lift I would recommend would be a vertical lift - it will tighten your breast skin and reduce and raise your nipple. Another option would be to reduce the nipple thru a scar around the nipple only, but these reduction results tend to be inferior to a more dramatic lift. Breast implants under your muscle - saline or silicone - would be fine, and there are benefits to each. Ultimately the scars will fade immensely, and in exchange you will get much improved fullness and shape. Good luck!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 50 reviews

Nipple reduction with breast lift

Nipple reduction is a common step in breast lift procedures and you could do well with either an around the nipple lift, or a vertical lift with an implant for improved volume and projection. Both scars, implant issues, and the potential for relapse or dilatation of the nipple after need be carefully discussed and considered during consultation.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Best Option for Large Areola and Larger Breast Size

An areolar reduction is a straight forward procedure that can improve the wide areola. That can be combined with a breast augmentation to increase the volume. Depending on the size of the implant, the areolar reduction may be part of a small breast lift. The best thing to do is be examined by a Board Certified plastic surgeon. You should be able to have it all done at once.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Breast improvement

I believe you would benefit from a breast augmentation and mastopexy.  This may require a circumferential incision only or may need an additional vertical incision depending on your tissue quality and exam.  Donald R. Nunn MD  Atlanta Plastic Surgeon. 

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 47 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.