Considering a second areola reduction surgery. More successful the second time?

Question

I had an areola reduction in december, and the results were great.However, once I started weight lifting, after approximately 4-5 weeks, the areolas increased in size and went back to the starting point. I am considering getting it done again as my surgeon says that it may be more successful second time - due to scar tissue already formed. I would really like a second opinion on this. Also, could it help to refrain from weights longer than 4-5 weeks? I started when my incisions looked healed

Daniel Barrett, MD · Answer

Dear Markmark92,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

It's doing the same thing twice and expecting a different result. Your areolar reduction didn't fail because you did something wrong. It failed because for the vast majority of people it's a bad surgery. You don't post photos so no advice can be given other than don't do it again.

Emmanuel De La Cruz, MD · Answer

Considering a second areola reduction surgery can be a viable option if you are not satisfied with the results of the first procedure. Success in a second areola reduction surgery depends on several factors, including the reasons for dissatisfaction with the initial surgery, the condition of the tissues, and the expertise of the surgeon. Here’s a detailed overview to help you understand what to expect and how to maximize the chances of a successful outcome:

Reasons for a Second Areola Reduction
Size: The areolas may still be larger than desired after the first surgery.
Shape: Irregular or asymmetrical areolas might not have been fully corrected.
Scarring: Prominent or unsightly scars from the first surgery.
Healing Issues: Complications such as poor wound healing or infection that affected the final results.
Factors Influencing Success in Second Surgery
Assessment of Previous Surgery:

Scar Tissue: Scar tissue from the first surgery can affect the complexity of the second procedure.
Healing Quality: The quality of tissue healing from the first surgery will impact the approach and outcome of the second surgery.
Surgeon’s Expertise:

Choosing a board-certified plastic surgeon with extensive experience in areola reduction and revision surgeries is crucial.
A skilled surgeon can assess the specific issues from the first surgery and devise a tailored approach for the second procedure.
Realistic Expectations:

Understanding the limitations and potential risks associated with revision surgery is important.
Clear communication with your surgeon about your goals and concerns will help align expectations.
Surgical Technique:

Techniques such as removing additional tissue, reshaping the areola, or improving scar appearance may be used.
Surgeons may use different suturing techniques or more precise excision methods to enhance results.
Post-Surgical Care:

Adhering to post-operative care instructions is vital for optimal healing and minimizing complications.
Proper wound care, avoiding strain on the area, and following up with your surgeon as recommended will contribute to successful outcomes.
Steps to Improve Success
Consultation:

Have a thorough consultation with a new or the same experienced surgeon to discuss what went wrong in the first surgery and what can be improved.
The surgeon will evaluate the current condition of your areolas, scar tissue, and overall breast tissue.
Customized Surgical Plan:

The surgeon will create a detailed surgical plan to address specific concerns, whether it’s size, shape, symmetry, or scarring.
A personalized approach increases the likelihood of achieving your desired results.
Proper Timing:

Ensure adequate time has passed since your first surgery, typically 6-12 months, to allow complete healing and tissue stabilization.
This waiting period helps the surgeon better assess the results of the first surgery and plan the revision accordingly.
Aftercare:

Follow all post-operative care instructions meticulously to promote good healing and minimize scar formation.
Use recommended scar treatments, such as silicone sheets or gels, and protect the area from sun exposure.
Summary
A second areola reduction surgery can indeed be more successful, especially with careful planning and execution by an experienced plastic surgeon. The key factors include a thorough assessment of the first surgery, realistic expectations, a customized surgical approach, and diligent post-operative care. Consulting with a highly qualified surgeon and adhering to their recommendations will significantly enhance the chances of achieving the desired outcome.

Connie Hiers, MD, FACS · Answer

They can enlarge again, and permanent sutures will be needed. You will need to hold off weight lifting for 2 months. However, there is always a risk of the areolae stretching again.

Camille Cash, MD · Answer

The areola restretching after a reduction procedure is not uncommon.  The tension on the incisions from the weight of the breast, etc can cause it to restretch.  This can happen with a secondary surgery as well.  I encourage you to visit with a few board certified plastic surgeons near you to listen to varying opinions on the recommended procedure that best matches your goals.

Considering a second areola reduction surgery. More successful the second time?

Answers (5)

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