Is this retained areola normal? (Photo)

Question

Posted a while ago with photos of what I thought was the staph infection that I got after my breast surgery. Apparently the staph is cleared up the doctor said but the whole area that I thought was infected was just retained areola. Does this look normal to you doctors? A friend suggested I look into malpractice

Paul M. Parker, MD, FACS · Answer

At your next visit, point this out to your surgeon and discuss with them. Leaving some areola behind is done to minimize the tension on the wound closure. As the scars and tissues soften, the retained areola can often be removed at a secondary procedure.

Adam Rubinstein, MD · Answer

Ideally, the best aesthetic result is achieved when you remove all areolar skin that is not going to be part of the actual areola after surgery. In some cases either for shape or tension control some areolar skin can be left behind. In my experience that is pretty rare, though possible. You can always seek another opinion to see if a revision would be helpful. The good news is that a revision is usually a much easier procedure than the original operation. I'm confident the excess areolar tissue can be eliminated if thats what you would like to do. I hope this helps! You can find more tips and useful information in my Instagram profile @plasticsurgerytruths

M. Scott Haydon, MD · Answer

Thanks for your question. The retained areolar pigment was done in an effort to minimize tension on the closure. This shows good judgment rather than malpractice. I would wait at least 6 months and consider excising the remaining pigment. Best of Luck!

S. Larry Schlesinger, MD, FACS · Answer

Retained areola on the vertical limb of a standard breast lift and/or breast reduction is often found present when one's pre-operative areola is very, very large.  You are to be congratulated on picking an excellent surgeon who gave you two truly nicely shaped breasts.  In the future, once your tissue relaxes which it always does (and usually sooner than we wish), then your surgeon can resect the unwanted areola tissue, make your nipple areolar complex smaller, and give you a slight lift all at the same time.These secondary touch up procedures are not unusual even in the best of surgical hands.  Building the perfect breast is not unlike building the perfect house.  There is always a punch list at the completion of the procedure.  We all want one and done, but cosmetic plastic surgery is always a process and hardly ever an event.  Communicate your concerns to your plastic surgeon.  I am sure he or she can work out these minor kinks.

Ven Erella, MD · Answer

Thank you for your question. Occasionally leaving some behind  to minimize the tension on the wound which helps for healing. This can be excised easily in six months to match to the other side. Please talk to your PS.

Matthias Solomon, MD · Answer

This is certainly not malpractice. As others had mentioned, your doctor did the safe thing in retaining part of the areola, but avoiding too much tension during the wound closure. Its is very easy to get this corrected. I would give it 4 to 6 months from the initial surgery; can be corrected in the office under local anesthesia.

Millicent Odunze Geers, MD, MPH · Answer

Malpractice? You got a nice result. Having large areolas preoperatively can result in having some residual areola with a breast lift or breast reduction. Better to have that than to remove all the areolar skin at one time, have too tight of a closure, which would lead to open/splitting wounds and skin loss, and possibly a need for reconstructive surgery. Instead, with time, as the skin relaxes, a procedure to remove the remaining areola can be done, even under local! Understandably your "friend" has your best interest at heart, but to suggest malpractice evidences that breast surgery is clearly not his/her expertise. Your surgeon was safe and cautious.

Joseph L. Hill Jr., MD · Answer

Hi there!  Thank you for your great question and photograph.  Retained areolas can occur sometimes if an individuals areolas are large.  They occur in an effort to prevent skin death from too tight of a closure during a breast lift or reduction.  They typically can be treated with an office surgery with a local anesthetic after waiting several months for the skin to relax.  I would suggest discussing matters with your surgeon.  Otherwise, you have an excellent result.

David A. Sieber, MD, FACS · Answer

Thanks for the great question and the photos. I'm guess you must of had pretty large areolas prior to surgery. What happens is that not all of the areola is able to be removed because taking it all out would then limit the amount of skin remaining to close the breast. When I see patients like yourself, I always warn them that there still might be come areolar skin after surgery. The good news is that the rest of the dark skin can be removed, the bad news is that it will take another procedure to remove everything. Aside from the pigment you have a very nice result. Best of luck!~Dr. Sieber

Benjamin J. Cousins, MD · Answer

Thank you for your question. The right appears more involved than the left, but I can see how both sides trouble you. The dark areas can occur along incision lines in breast lift/mastopexy and with breast reduction surgery, and yes there does appear to be retained areolas tissue there. The areolas have some "stretch" to them as well and this would be more likely to be present if you started out with very large and wide areolas to begin with. Pre-operative photos and a review of your surgical procedure would be a good starting point with a Board Certified Plastic Surgeon. Excision of the darker areas of the areolas can be discussed.Sincerely,Benjamin J. Cousins MDBoard Certified Plastic Surgeon-Miami, Miami Beach

Is this retained areola normal? (Photo)

Answers (13)

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