Breast reduction and lift - would areolas need to be moved? Would I lose sensitivity? (Photos)

Question

I had a panniculectomy in January 2025. I now feel top heavy and want to have a breast reduction and lift. What would the procedure entail? Would I need to have my areolas moved? If so, would I lose sensitivity?

Christine Fisher, MD, FACS · Answer

Hi Ravina!  Breast reductions do involve "moving" the nipple to lift the nipple to a more aesthetic position, but typically the nipple/areola complex stays connected to the tissue below and the entire pedicle (mound) of tissue is repositioned.  In rare occasions, in patients with extremely large breasts, then nipple/areola is removed and grafted to it's new position.  As far as sensation, although I personally try to maintain as much nipple sensation as possible during a typical breast reduction, there is the chance that you could lose some amount of sensation.  I highly recommend discussing this in particular with your surgeon.   I encourage you to seek out a board-certified plastic surgeon to see if you are a good candidate for the proceudure.  Best of luck!

Emre Guvercin, MD, FEBOPRAS · Answer

You’re asking the right questions &mdash; especially after a panniculectomy, it’s very common to feel top-heavy and want better balance.What would the procedure involve?In your situation, the most appropriate approach is a Push-Up Breast Reduction & Lift. This technique:Reduces excess breast weightRepositions your own breast tissue upward and inwardRestores a lighter, more balanced silhouette after lower-body contouringImproves shape and upper-pole fullness without relying on implantsIt’s a structural reshaping, not just skin tightening.Would the areolas need to be moved?Most likely, yes &mdash; but not in the way many patients fear.In a Push-Up Lift:The nipple–areola complex is typically moved to a more natural, higher positionCrucially, it remains attached to its blood supply and nerves (no free nipple graft)This is done to match the new breast shape and relieve the “top-heavy” lookSo yes, the areolas are repositioned &mdash; but safely and anatomically.Will I lose nipple sensitivity?With a tissue-preserving Push-Up technique, the risk of permanent sensation loss is low.What to expect:Temporary changes in sensation (numbness or hypersensitivity) are common early onSensation typically improves over monthsMost patients retain protective and often erogenous sensationThe highest risk of permanent loss occurs with free nipple grafts, which are not indicated in your caseBecause the nipple stays connected to its nerves, sensation preservation is a key advantage of this approach.Why Push-Up Lift is especially suitable after panniculectomyAfter removing lower abdominal tissue, the body’s balance changes. A Push-Up Breast Reduction:Removes upper-body weight contributing to back/neck strainRe-centers the breast mound for better postureAvoids an over-flattened resultCreates harmony between upper and lower body contours
If your main concerns are feeling top-heavy, maintaining sensitivity, and achieving a natural lift, this approach is well-suited to you. A consultation with a surgeon experienced in Push-Up Lift techniques can tailor the plan precisely to your anatomy and goals.

James N. Romanelli, MD, FACS · Answer

Dear Ravina

Breasts commonly enlarge after menopause.  Based on your photos you would benefit by a breast reduction and lift.  It does involve moving the areola and nipple to a higher position.  Nipple sensation can be diminished, but rarely fully lost, after a breast reduction.

Below is a link to a similary shaped patient of mine, before and after breast reduction.

Best of Luck
Dr. Jim Romanelli

Caner Kacmaz, MD · Answer

Yes areolas would be smaller (standard 4cm) and adjusted accordingly. Loss of sensation might initially occur but it will come back in time.

Justin Yovino, MD, FACS · Answer

The breast reduction, including a lift, would be performed using an anchor pattern scar. That involves removing excess skin and breast tissue through incisions that are closed in a final pattern that resembles an anchor or inverted T. The nipples and areolae are elevated to a more lifted ideal position. The areolae are not removed. They stay attached to you and are shifted superiorly. It is possible that nipple sensation decreases partially or completely. On some occasions the nipple sensation can increase, but that's unusual. I go over all of these details during the consultation. We also perform this procedure without the need for general anesthesia. It's performed in the office under local anesthesia. Yes! A full breast reduction is performed with complete numbing and relaxation using injection of local anesthesia and oral medications. Check out the youtube video

Shitel Patel, MD · Answer

A breast reduction and lift can absolutely help restore balance and comfort after a panniculectomy. Repositioning the areolas is part of the process, and while some change in sensitivity is expected, complete loss is uncommon with standard techniques. I recommend a thorough in-person consult to determine the best surgical plan based on your anatomy and goals.

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Hi, thank you for this question. Breast reduction is also is a breast lifting procedure. When we perform such operations we move your areola to a higher position. There is a slight chance to damage your nerve but it is really a small possibility. I think you mean if your areola would completely removed and then reused a graft. In that case of course you will lose your nipple sensation. But you won’t need this kind of surgery. You seem to be a good candidate for breast reduction with pedicle which aims protect the sensation.

Donovan Rosas, MD · Answer

Reduction and lift are similar (if not identical) procedures done for different reasons. A lift primarily lifts and the breast will tend to get smaller as a consequence. A reduction primarily reduces but will lift as a consequence. In summary, the 2 are inseparable.

With regards to your specific question, the operation typically involves formation of a pedicle or a protected area of breast tissue containing the nipple and areola. This area will preserve blood supply to the new smaller breast. Anything outside of this protected area can be removed to reduce the size without compromising the breast blood supply. While sensation is not guaranteed, it is typically preserved (and at worst altered). An anchor scar is standard.

Based on your photos, you would appear to be a reasonable candidate.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ajaya Kashyap, MD · Answer

Thank you for your query. Areolas have to be moved up for a breast reduction and lift. Permanent change in nipple sensation is unlikely. Please find an experienced board  certified Plastic surgeon who can examine you and help you with all your concerns. All the best.

Karl William Schwarz, MD · Answer

You are a perfect example of someone who typically undergoes a breast reduction. Your breasts are heavy, sitting on your abdomen, low set nipples from droop and shoulder grooving and one can only assume neck and back pain and possibly headaches as well related to your very heavy and pendulous breasts.

All breast reductions are best considered to be a lift and then at the same time we perform the lift we also reduce the breasts by removing breast tissue and breast fat. So all breast reductions automatically come with a lift which will move your nipples and areola to a much higher position.

Usually patients maintain their sensation of their nipples and frequently for patients with a lot of droop will actually get an improvement in their nipple sensation after a breast reduction.

Breast reduction and lift - would areolas need to be moved? Would I lose sensitivity? (Photos)

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