Breast augmentation with or without areola reduction?! (photos)

consult in June. I am 5'4" 145 lbs. 3 children, currently a 36C, previously 34DDD. Looking to return to size and regain fullness and possibly reduce areola a little, are considerably smaller when cold/aroused. Would like minimal scaring. What are my options? Will peri areola or doughnut w reducing areola provide a little lift w larger implant providing some lift too or will larger implant alone be ok? What will look best based on the pics provided, will implants alone make areola bigger?

Doctor Answers 12

Breast augmentation and areolar reduction, some advices:

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Thanks for the question.
I prefer use the Cohesive Gel - Silicone Breast Implants with textured cover ("gummy bear implants") They are quite safe and aesthetically best as they give a firmer consistency, better projection and natural appearance.
To place the implants, I recommend making the incision through the areola (leaving an unnoticed scar) in conjunction with a Round Block Areolar Reduction to get an appropiate areolar diameter, with a minimal and hidden scar (a circumference line surrounding the areola).
Kind regards,
Dr. Emmanuel Mallol.-

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 372 reviews


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I would recommend a mastopexy, with or without implants. A larger implant will increase the risk of sagging. The areolae would be reduced during the mastopexy.  Determining which lift option is best for you would require a physical examination. Everyone wants the least amount of scarring possible but the technique has to be weighed against the presentation and desired outcome, including longevity.

Breast augmentation with lift

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Thanks for your question and for including the photos.

You would be best served with the implants and a lift.  The lift will reduce both the droopiness and size of the areoals.  It can be done with the periareolar mastopexy scar (doughnut).

Best of luck in your decision.

Dr. T

Douglas Taranow, DO, FACOS
New York Plastic Surgeon
4.8 out of 5 stars 65 reviews

Breast lift with augmentation

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Thank you for your photos and questions. An in-person evaluation with a board certified plastic surgeon is always the best in determining what procedures(s) are best for you. 
Judging solely on your photos, you will most likely need a breast lift to create a more youthful, perkier breast. The lift will also reduce the size of your areola. If you want to return to your previous size, you can have an implant inserted at the same time as the breast lift. For you, I would not recommend a breast implant alone as the weight of the implant will cause your breasts to droop more.

Best of luck,

Mennen T. Gallas, MD
Katy Plastic Surgeon


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Breast Augmentation is an excellent way to both add volume to smaller breasts and, when combined with a lift, to restore a youthful appearance to breasts that have started to droop or sag. No one wants a mastopexy (lift) but unfortunately some women need them. I would recommend a mastopexy + implants for the most pleasing result and would strongly discourage just implants. Implants will cause your breast to sag further and your result will be less than desirable. Best Of Luck.

Breast Lift with Implant

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I would recommend a breast lift with implants.  There are several types of breast lift incisions. I would recommend an in-office examination as well as a detailed discussion with a board certified Plastic Surgeon.

Best wishes!

Dr. Desai
Harvard Educated, Miami Beach and Beverly Hills Trained Double Board Certified Plastic Surgeon

Lift with implants?

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It actually looks like you have enough breast tissue for  a lift alone. If you want implants, then they can be added.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast lift with implants

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From your pictures, you would benefit most from a vertical lift along with implants. A vertical lift will give you a lollipop scar, that is a scar around the areola and a vertical scar that goes from the areola to the fold. Please see qualified board certified plastic surgeons in your area who have experience with combined augmentation and mastopexy. Good luck!

Implants with Lift

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I appreciate your concern, but it appears that breast lift with implants is your best option. This would address the shape,droop and lack of fullness of your breasts, and also correct your large nipple-areolar complexes. I do not think the technique you are describing will provide enough lift, even with large implants. There are other risks and issues with this approach, like scarring, and pan caking of the implants,so be sure to consult with a board certified plastic surgeon. Good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast lift w/ augmentation

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Hello and thank you for your question. Based on your photograph, you may benefit from a breast lift with augmentation.  This can be designed in a way to minimize scarring. The most important aspect is to find a surgeon you are comfortable with. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 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.