Can complications arise from breast augmentation for women with small areolas?

I have very small, light areolas. In my research I learned that many physicians will make an incision on the areola and use that to push the implant into place. Is this option out of the question for a woman like me?

Doctor Answers 8

Can complications arise from breast augmentation for women with small areolas?

When I examine a breast augmentation patient I take note of the diameter of the areolae to be certain they are of adequate size for placement of an implant.  It isoften surprising how with the use of a Keller funnel how well an implant can be positioned but not for everyone.  If your areolae are truly too small, I would recommend the use of a transaxillary incision made in the peak of your underarm and avoidance of an inframammary crease incision.  Others will disagree but that is based on my three decades of experience using both transaxillary and periareolar approaches.  Best wishes and good luck,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Areola size and breast augmentation.

Thank you for your question.  The size of the areola can limit the peri-areolar approach or incision.  If the areola is small and the implant chosen is large, this may not be the best incision.  A lot of surgeons will use the Keller funnel, especially with the peri-areolar incision, but there are limits.  Best to have an examination and your surgeon can guide you on the best incision.


Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 30 reviews

Small areolas

Thanks  for your question. It's difficult to fully answer this question without knowing the specifics of your case. In order to perform a breast aug using a peri-areolar approach you can use saline implants or small silicone implants when you have  small areolas. In my opinion a peri areolar approach may not be the choice for you based on what you mentioned. Select an experienced Board Certified Plastic Surgeon and discuss your options. Good luck. 

Mehdi K. Mazaheri, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 20 reviews

Can complications arise from breast augmentation for women with small areolas?

Thank you for your question. I recommend not to go through peri areolar when they are small. Recommend infra mammary creese incision. Please talk to your PS

Can complications arise from breast augmentation for women with small areolas?

The areolar incision cannot be used when the areolas are small because placing an imlant through a small incision could tear the areola. Thus you will likely need an incision underneath the breast. After breast implants the areola will enlarge

Breast Augmentation Via an Areola Incision

It takes a certain size incision to work through in order to accomplish the surgery. For women with small areolas we use the incision in the fold, or extend the areola incision about 1/2" off to the side. The extra scar is negligible and it allows the patient to have the incision where they prefer. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast Augmentation

Thanks for your inquiry. While some surgeons use the areola as the incision site for a breast augmentation, many use a submammary incision and avoiding the areola altogether. I suggest that you schedule a consultation with a board certified plastic surgeon in your area to discuss your options.

Brian Widenhouse, MD
Charleston Plastic Surgeon
4.1 out of 5 stars 36 reviews

Can complications arise from breast augmentation for women with small areolas?

When the areola is too small it's best to use another incision to place the implants. In my office this is an incision placed through the crease, but some surgeons place implants through an axillary incision. Speak with your surgeon about their recommendations.

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.