Areola Reduction before, after or with augmentation?

Question

I am interested in areola reduction and also breast augmentation. Ive reached out to multiple doctors with most of them saying these two procedures can be performed together. However there are a few that have said doing these together would put strain on the areola suture and would be better performed as a breast lift which will address both. I am trying to avoid a lift altogether and I prefer OTM augmentation for recovery purposes. My question is if I wanted both of these procedures should they be done together or separately?

Wayne I. Yamahata, MD · Answer

I personally would recommend separating or staging the procedures. Scars from an areolar reduction are seldom ideal and the added tension from an implant would increase the risk of unfavorable scars. I would favor placing the implants first, then waiting 6 months or more for the tissues to relax, before performing the areolar reduction.

Julia Spears, MD · Answer

Whether areola reduction and breast augmentation should be performed together or separately depends largely on your anatomy, skin quality, implant size, and aesthetic goals. There is no single correct answer for every patient.

The concern with performing both procedures at the same time is that the implant can place additional tension on the areolar incision, which may increase the risk of scar widening, stretching of the areola over time, or recurrent enlargement. This is particularly important in patients with tighter skin or when larger implants are being used.

On the other hand, in appropriately selected patients, areola reduction and augmentation can be performed together successfully. The key is ensuring that the tissues can accommodate both procedures without excessive tension on the closure.

Hello, and thank you for your question. If your goal is to avoid a breast lift, a staged approach may be worth discussing. In some cases, placing the implant first and allowing the tissues to settle before performing an areola reduction can provide more predictable scar quality and areolar shape. However, this does mean undergoing two separate procedures and recovery periods.

A consultation with a board-certified plastic surgeon can help determine whether a combined procedure or a staged approach would provide the safest and most aesthetically pleasing result based on your individual anatomy and goals.

Safa Sharabi, MD · Answer

Hi there,
It depends on your anatomy- if you have enough skin laxity, these potentially could be done together. But if you have minimal excess skin, doing the two procedures at the same time might cause the scar to widen and for you to have a subpar result.
Sincerely,
Safa Sharabi

Daniel Barrett, MD · Answer

Dear melusina33,

it is hard to tell for sure without an examination. Generally speaking, it is probably the best option to do it at the same time as BA. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Yes, in many cases you can combine an areola reduction with a breast augmentation.  However a consultation is recommended to determine if you are a good candidate.  Variables that will influence this are the size of your breasts currently, the implant size you are considering, and the level of sagging you currently have.  Visit with a board certified plastic surgeon near you to learn more.

Areola Reduction before, after or with augmentation?

Answers (5)

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