Should I Have Another Aerola Reduction? (photo)

I had a BA with aerola reduction about 2 years ago and was initially happy with the results. The scars have healed ok however the aerola has stretched out and is now large again. I'm satisfied with results as they are so much better than before but am considering aerola reduction again. I'm worried that a revision would do more harm than good and the scars will be worse second time round. Any help would be much appreciated. Thanks

Doctor Answers 3

Large Areolar Reduction

Hello Turns1234 For having a circumareolar lift, your scars have healed well. This procedure can achieve an approximately two cm lift in the position of the nipple, but it doesn't tend to be able to decrease the size of the areolae. If you desire a more reliable way to reduce the size of your areolar, then you need to consider a "lollipop" or "V" lift which entails accepting a vertical scar from your inferior areolar edge down to the lower breast fold. This procedure allows the creation of a smaller outside areolar diameter which would match the size of your desired areolar size and therefore your areolar size will stay how it is created. This procedure also the added benefit of tightening the lower curve of your breasts, making them appear perkier and more youthful.  Many women are scared of this vertical scar, but it tends to heal even better than the scar around the areola. You will probably find that the minimal scar is worth the benefits it can deliver.  Best of luck to you.

Newport Beach Plastic Surgeon
5.0 out of 5 stars 35 reviews

Areola revision is possible, but have realistic expectations!

Your areolas can indeed be reduced and made more symmetrical with repeat surgery. However, there are limitations as to the size or degree of reduction possible without causing excessive pleating, bunching, or scar irregularity. This is simple mathematics--your present areolas have a certain circumference (pi x diameter), and the desired smaller diameter will have a shorter circumference. These two different lengths of incision must be sewn together, and the more the discrepancy, the more the pleating and scar irregularity.

In essence, your surgeon must "purse-string" the larger circle to match the smaller circle, which will stretch as well. Non-dissolving ("permanent") purse-string sutures can be felt and often seen, but can help to keep the areola stretch to a minimum. Dissolving sutures will eventually be gone, and scar tissue will eventually stretch, allowing areolas to return to somewhere between where they were before revision and where they started right after revision was completed.

So, as long as you understand that even careful, precise, and skilled plastic surgery cannot overcome the laws of physics, additional improvement is indeed possible--up to a point. Or, a modified or full breast lift may be a consideration, but with the understanding that there will be more scarring and cost. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 238 reviews

Areolar reduction often needs revision

Hello. I do many areolar reductions both as an isolated procedure and on patients with large areolae. No matter how small you make the areolae at surgery it will always stretch and especially if you are doing implants in combination. I do not use a permanent suture because you always feel this later and need it removed. I always tape after surgery for about 3 months. Even if you make the areolae very small it will stretch, sometimes more the smaller and tighter you make it. Revision will help, but it will stretch again, just not as much. Don't forget your nipple will get smaller and smaller the more the areolae is stretched. It looks like you will surely benefit and you can also have the result create more round areolae.

James Romano, MD
San Francisco Plastic Surgeon
4.9 out of 5 stars 11 reviews

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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.