Can I have my areolas made smaller if I have Breast implants through the periareolar incision?

Question

I know you can have the size of your areolas reduced, but can you have it done at the same time as your breast augmentation if you opt for the periareolar incision. My areolas are already very large for my breast size. I know breast implants stretch out everything including the areolas, and I'm wanting pretty large implants.

Terence Michael Myckatyn, MD · Answer

Genreally the areola can be made smaller through a periareolar incision - and more specifically a circumareolar incision. Variables include the size of the areolas to start with, firmness of the breast before and after placement of the implant, and therefore implant size you chose. The larger the areola to start and the firmer the skin behind the areola - possibly due to a larger implant - the less they can be safely reduced. Or, they can be safely reduced but may lead to widened scars. So, yes they can often be reduced but this question is best answered in person by a board certified plastic surgeon experienced with this technique. Best of luck!

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well..

The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue… Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.

Peter A. Aldea, MD · Answer

Areolas CAN be reduced in diameter at the time of a Breast Augmentation. However, any tension placed on the stitching would result in an expanded abnormal looking "star burst" appearance. For a scar to heal nicely it must be closed under little to no tension. If the areolae are reduced after large implants are placed the pressure of the implants on the breast skin pushes it forward like a sail resulting in slow stretching of the skin but especially the freshly operated on incision.   Discuss this carefully with your surgeon to make sure you are not disappointed. Dr. Peter. A. AldeaMemphis, TN

Robert Singer, MD · Answer

It is certainly possible to reduce the size of the areola in the appropriate patient at the time of a breast augmentation with a periareolar incision. Keep in mind that following the
advice from a surgeon on this or any other website who proposes to tell you
exactly what to do without examining you, physically feeling the tissue,
assessing your desired outcome, taking a full medical history, and discussing
the pros and cons of each operative procedure would not be in your best interest.
I would suggest that your plastic surgeon be certified by the American
Board of Plastic Surgery and ideally a member of the American Society for
Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You
should discuss your concerns with that surgeon in person. 
Robert Singer, MD FACS
La Jolla, California

Tom J. Pousti, MD · Answer

Yes, it is generally possible to reduce the size of the areola at the time of breast augmentation surgery. It will be important, as you consider decisions, to carefully weigh the pros/cons associated with areola reduction surgery. My best suggestion: select your plastic surgeon carefully. He/she will be able  to educate you regarding the potential risks/complications associated with all options discussed.  Best wishes.

Bryan Michelow, MD, FACS · Answer

The reduction of the areola can be performed with a periareolar incision and can be done at the same time as an augmentation. You are correct that even if the areolas are minimized it is possible they can still stretch with the insertion of a large implant.  Please make sure to discuss this with your board certified plastic surgeon.

Richard Kofkoff, MD, FACS (retired) · Answer

Yes it is usually possible to reduce the size of the areola at the same time as performing an augmentation through an areolar incision.  It is important to understand, however, that the bigger the implant the tighter the skin will be and, therefore, it will take more tension to reduce the areolar size.  This is significant as more tension means there is a greater possibility that the areola will stretch again.  You should discuss this with your surgeon before proceeding.

Andrew Kaczynski, MD (retired) · Answer

It is quite possible to reduce the size of the areola while doing  a periareolar  incision. This is basically a mini version of the Benelli or circumareolar breast lift technique. In this technique a donut  of skin is removed around the areola enough to decrease the size to the desired range. Then a permanent  purse string suture his placed. It is tied down to the desired diameter and then the incision is closed.  Your best option is to discuss this with a board certified plastic surgeon who is very experienced in this technique and breast surgery in general.

Can I have my areolas made smaller if I have Breast implants through the periareolar incision?

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