Mild Tuberous Breast correction. Getting Breast Aug, but do I really need an areolar reduction?

My Dr suggested I might need a areolar reduction. He said I can get it later but why knock out 2 birds with 1 stone right? My issues are, I am afraid of having those type of scars & have read the scaring does stretch over time. Since I do have a mild form, do I really need the reduction?Can be fixed through just the fullness of the implant? & if I don't go through with the reduction will my areole spread and get bigger?I DO want to get rid of this issue, the question is- What approach do I take?

Doctor Answers 15

Mild Tuberous Breast correction. Getting Breast Aug, but do I really need an areolar reduction?

If scarring around the areolae is a significant concern to you, you should address this with your plastic surgeon.  Breast augmentation alone should provide you with larger, fuller breasts. But your areolae will mostly likely remain a bit puffy in appearance. This could be diminished with radial incisions under the areolae without the need for scars around the the areolae. The best thing to do is communicate with your surgeon. Thank you for sharing your questions and photos. Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

Would not recommend it, unless you are bothered by your NAC size

Your breast shape and areola size looks great.  You do not have ptosis or a droopy breast and I agree with you: why place those incisions around your areola if you do not need to?

The photos illustrate what appears to be an excellent candidate for breast augmentation.  consider highly cohesive gel implants or gummy bears as they are by far the best implants in my opinion offered.  These are the 5th generation implants, like those from Sientra.

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 87 reviews

Unnecessary areolar reduction

Thanks for the question. I don't recommend an areolar reduction due to the inconsistency the outcome. Your breast will look fine with the mastopexy alone.

All the best,

Dr. Results
Miami, FL

Jose M. Soler-Baillo, MD
Miami Plastic Surgeon
4.7 out of 5 stars 92 reviews

Correction of a tubular breast does not require a mastopexy necessarily.

For most cases a constricted breast can be treated by a a sub glandular implant with a mastotomy alone. Mastopexy is not needed and from the photographs I don't think you need a mastopexy.

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

With mild tuberous breast deformity, can I get a breast aug without the lift?

Hello and thank you for your question.  Many women are concerned about scars, but I recommend doing what will give you the best outcome.  Naturally I could give you a better assessment after an in person examination, but based on your photos, it appears that you have a very mild tuberous breast deformity.  I have treated several patients with breasts shaped similar to yours and performed a breast augmentation with aggressive dual plane and achieved great expansion of the lower pole of the breast, great projection/cleavage, and an aesthetically appealing shape.  In your case, since you are so concerned about scarring, I would consider doing a dual plane breast augmentation.  If for some reason later on you are still unhappy and your nipple-areola complex appears too large and pointy, you could opt for a circumareolar lift, some radial scoring, and a reduction in the size of your nipple-areola complex (although I think you will be pretty happy with the dual plane augmentation alone). Make sure to discuss your concerns with your plastic surgeon and come up with a plan that is reasonable to your expectations and their level of expertise.  If you are not certain of the plan, you have the option of seeking a second opinion.  I hope this helps!

Sean Kelishadi, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 27 reviews



Its difficult to tell for sure from your photos, and I would have to examine you, but you may not have tuberous breasts. In that case, a straight forward augmentation would work fine.

It always helps to get a second consultation from a plastic surgeon if you are not sure about the situation.

I hope this was helpful,
Dr. Daniel Barrett
Plastic Surgery
Beverly Hills, CA

Daniel Barrett, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 66 reviews

Areolar Reduction


Keep in mind that an areolar reduction is really a lift that reduces the surface area of your breast skin envelope, and breast augmentation increases the volume of the breast, and therefore expands the skin surface area.  These are two competing processes, and the resulting closure will be tight. If you are concerned about scaring, you should know that your scars are likely going to be worse (and you're likely going to see more areolar expansion) if you do them simultaneously.  

For many tuberous breast patients, staging (if necessary) of the augmentation and lift is a wise decision.  For those that think that they want just one surgery, they should know that there is a high percentage of tuberous breast patients that end up with two or more surgeries, many unplanned. Because of the difficult nature of the deformity, it's best to be cautious. 

Best of luck, I'm sure you can get a great result!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

Mild Tuberous Breast correction. Getting Breast Aug, but do I really need an areolar reduction?

Dear mmelbear

In making your decision, consider the following:

After augmentation, the areola always gets bigger and stretched out, you can easily see this by looking at a series of before and after pics

The circumareolar scar is unpredictable and highly variable, in addition, it forms a flatter less projected breast

The safe approach is to have your augmentation, wait 6 months and then if areola was too big for you, and you were willing to trade a smaller areola for a scar, have an areolar reduction. Then its much more predictable and consistent in outcome. You are likely to make a better decision that way. Once you have the scar, you cant go back.

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 57 reviews

Do not do an areola reduction

First you do not have tuberous breasts, they are normal small A cup breasts.  Second you do not need an areola reduction.  When you try to reduce the areola such as a periareolar mastopexy or Benelli mastopexy then stuff a big implant under the breast you are putting a lot of tension on the areolar repair.  Tension causes the scar to stretch and widen so you end up with really ugly scars and a wide areola over time.  So just go with a breast augmentation with minimal scars.  The areolas will not look big compared to the larger breast. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 92 reviews

Do I really need an areolar reduction

You seem really to have already answered your own question.  If you don't want to have the areolar reduction, don't do it.  By the look of your pictures, your areola do not appear excessively large, but keep in mind that adding implants will stretch them slightly.  It is always best, in my opinion, to take a conservative approach to surgery.  Something that was not done can always be done later but what is done cannot be undone.  Best of luck with your surgery!

Jeffrey A. Sweat, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 44 reviews

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.