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

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.

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. ResultsMiami, FL

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.

Mmelbear,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 BarrettPlastic SurgeryBeverly Hills, CA

Hello,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!

Dear mmelbearIn 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 picsThe 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.

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!

Good Morning.  You have stated your concerns here clearly, and hopefully with your Dr. as well.  The advantages of correcting the nipple at this time are to keep it small, and to flatten the tuberous (although mild) shape.  The other answers are correct that the implant is not that likely to do that.  If you choose to have the nipple corrected, I believe it is still important to use a permanent suture around the areola to help prevent spreading.  In addition, In my practice I recommend to patients that they use the inframammary incision to place the implant, and then use the Nipple incision only to reduce the areola.  Even though this is two scars, they both do better, and there is statistically less chance of capsular contracture by not going through the nipple to place the implant. Finally, I do believe the newer form stable or cohesive implants will help shape the breast better in this situation.Best of luck in your goals.  Dr. Schwartz

Thank you for your question.I recommend visiting your plastic surgeon again, and expressing your concerns. Your questions are good, and valid points to address.  Scarring is unpredictable, some patients scar poorly, and others form thin scars. It is difficult to predict if your scars will stretch. Also, in general, augmentation does not reduce the areola size, and sometimes the swelling and size of the implant can make the areola appear larger. If you are still unsure after re-consultation with your plastic surgeon, a second opinion may help you make a sound decision. Good luck!Regards,Manish Champneria, MD

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!