Areola reduction for "puffy" nipples? 22 year old woman (Photo)

 Your best options included areola reduction, breast augmentation, or both. Either way you will require surgery to improve this condition.  Areola reduction will involve an incision around the circumference of the areola and a permanent suture.

Thank you for your post. It does seem for your photographs and description that you have at least a mild form of tubular breast deformity. This condition comes in a variety of presentations. It typically involves tightness of the lower aspect of the breast, and what appears to be herniation of the breast tissue through the areola. There are several other nuances to the actual diagnosis, but that is the overall picture. Many surgical approaches have been designed to treat this condition. It depends on your particular case. At least some narrowing of the areolar

Your breasts appear small and somewhat constricted, which is what we surgeons term a "tubular" breast.Realize that the puffiness is due to breast tissue directly under the nipple.  Any attempt to remove it would cut through all the nerves and breast ducts leading to the nipple.  This is never done.  And cutting out a donut of the areolar skin (to make the diameter smaller) would only leave a scar which could widen over time -- and the puffiness would probably remain as well.The only way to help you would be to disguise the puffiness by injecting fat surrounding the areola so that the entire breast is larger and would come up to the level of the puffy nipples.Elliot W. Jacobs, MD, FACSNew York City