What Happened to my Areola That 5 Months Post is Now Huge? (photo)

Have never been too happy with results, to add insult to misery, all of a sudden my left nipple have expanded! Almost like something snapped and now it is huge! I asked my doctor about it and he said all was "normal". I asked him to measure, and it was indeed a couple of cm larger. He said he could fix it by reducing the nipple but, never told me why did this happened, or if I can expect this to happen on my other breast as well. I also have ridges under that one breast.

Doctor Answers 12

Breast lift

If I were you, I would consider finding a surgeon with experience doing a large number of standard breast lifts, and let him revise your lift.

Columbia Plastic Surgeon
4.9 out of 5 stars 73 reviews

What Happened to my Areola

I can only give a possible explanation. Sometimes to control the areolar size a permanent suture of goretex is placed as a pursestring. Later, if that unties, the areola will expand to the size it would have been had the suture never been places. You can probably tell by feeling for a similar suture on the other side--if it's there, it will be obvious.  

This will need to be revised at some point. The ridge could be addressed at the same time, though I do note improvement since the nest most recent photo, so this may continue to improve, as it seems to have done on the other side.

Thanks for your question, and for the photos which were very useful. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Areola and increase in size

With a snapping sound, perhaps a permanent suture was placed to control the size of the areola. With the suture rupture, it relaxed. It may just take  minor revison to correct this.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast Lift Areolar Widening

   The breast lift result can be revised and the areola reduced as well as the other area touched up.   The lift pattern can be modified or another pursestring suture placed.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Concern about an acutely enlarged areola 5 months post breast lift

Without knowing exactly how your procedure was performed, particularly in the treatment of your areolas, it would only be speculation as to what happened. However, if indeed, there was an acute enlargement of the areola as compared to a gradual enlargement, this would support the breakage or undoing of an internal control suture that was placed around the areola to limit its size. If you feel around the perimeter of your other areola and there is a firmness circumferentially, this would support the theory of the suture.

Regardless, it appears that you will definitely benefit from a revision at some point in time.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Areola Enlargement after Breast Lift

One unresolved issues with augmentation mastopexy, whether vertical or peri-areola is maintenance of the surgically created areola dimensions.  As part of the lift, 2 different circumferences are created.  The first circumference involves the areola itself and the second is the new elevated position created by skin excision.  That circumference is almost invariably larger than the circumference of the areola itself, which creates tension.  As surgeons we try to counteract this tendency to expand from the tension, by using a pursestring suture of either a long lasting nature or one that is permanent.  Unfortunately this is not always successful. 


In your case, the pursestring suture may have come undone or snapped allowing the areola to expand.  We see this problem with areola expansion more often in the peri-areolar or Benelli lift, because there is a greater propensity to expand by not having the inferior excision of tissue that is part of a vertical mastopexy to relieve some of that tissue.  That being said, fortunately a re-excision to make that areola smaller is a fairly straight forward procedure and hopefully in your case do the trick.  

William F. DeLuca Jr, MD
Albany Plastic Surgeon
4.9 out of 5 stars 183 reviews

Operative technique influences the likelihood of asymmetries after breast surgery.

Without the specifics of your operation it is impossible to render an opinion about why the areolar asymmetry. If the areolae were sutured under different tensions this could ensue. Nevertheless, it looks like a revision will be necessary to achieve symmetry.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Enlarging nipple after breast lift

Scars often stretch after breast lift surgery and sometimes the scar around the nipple requires revision, but typically scar revision occurs no earlier than 6 months after surgery, maybe longer. Using a permanent suture like Gortex will help maintain shape. Maybe your surgeon used a permanent suture and this is what snapped. You should ask questions about this.

From the photos and description it is unclear how old you are, how far out from surgery you are, and if you had baseline mammogram? If you have any concern, you may need to have breast imaging to assure there is no problem with the underlying breast tissue.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 53 reviews

Concerns after Breast Augmentation/Lifting Surgery?

I'm sorry to hear about your dissatisfaction after breast augmentation/lifting surgery. The most plausible explanation for the recent onset of areola spreading is  that a suture used around the areola has broken. Sometimes, as dissolving sutures dissolve the areola may spread as well.

 Generally speaking, you may benefit from revision breast surgery to improve the areola and breast symmetry;  additional skin excision may help improve the appearance of the “ridges” below the breasts.

 I would suggest that you discuss your concerns in a calm/constructive fashion with your plastic surgeon.  If in doubt, seek additional consultation and persons with other certified plastic surgeons in your area.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Change in Areola After Implant and Lift

Thank you for the pictures.  It appears that the size of the areola changed because it relaxed as the sutures dissolved.  This why when I perform an augmentation and lift I use a permanent suture around the areola to "lock" in the desired size of the areola.  Not really sure why you have pleats on the left breast.

Dr. ES

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