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

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

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

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!

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

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.

Thanks for your question! Yes, your areolas would be moved upwards. There is a small risk of numbness to the nipple, but for many patients exploring this surgery, it is worth the risk! Best of luck!

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.

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).

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.

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.