What Do I Need to Know About Areola Reduction?

I'm 20 years old and very unhappy with the size of my nipples and and considering surgery. They are both about 8-9 cm in diameter. I have no plans to have children in the near future. What do I need to know about nipple surgery?

Doctor Answers 5

Areola reduction

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I would recommend seeing a plastic surgeon for an evaluation in order to discuss your options. Your areolae may be enlarged if the breasts are very large, or if you have tuberous breasts, in which the breast tissue tends to grow out and "flop" down instead of forming a typical round mound on the chest. Areola reduction itself is a straightforward procedure in which the excess pigmented tissue is removed and sutures are placed around the entire areola. However, if you have large breasts or tuberous breasts, additional surgery on the breast might be necessary to achieve the shape you desire. Many women still have normal sensation of the nipples and are able to breastfeed after this type of surgery. Good luck.

Areolar Reduction

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Although it seems like it would be easy to just cut the outer circumference of the areola to reduce the diameter, there are a number of things to consider regarding the outcome.

Lets say that with your diameter areola of 8 to 9cm, (this is quite large) you wanted to have a reduction to a 4cm diameter. This means that the radius of the your areola will be reduced by 2 to 2.5 cm. When this is done, the nipple will essentially be raised that much higher on your breast. This is OK if your breast are sagging but if they are not they could be sitting too high.

Another important thing to consider is that the difference in circumference between a 8cm diameter and a 4 cm is over 12 cm. This means that the big circle left on the outside of the areola which was left after cutting away the nipple border has a circumference 12cm larger than the new nipple border. If this is sutured without a permanent suture to retain the diameter, then the big outer circle will eventually stretch the smaller areolar circle back to close to it's original size. There is also a chance of puckering around the border.

An areolar reduction does not interfere with breast feeding but make sure you consider the above issues. I would recommend a compromise to my patient of maybe a diameter of 5 to 6 cm to reduce the discrepancy.

Leslie H. Stevens, MD
Beverly Hills Plastic Surgeon

Areola reduction.

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Areola reduction surgery may be very effective in reducing the size of the areola. However, this procedure may be associated with unsatisfactory results. For example, you may find that the breast profile is flattened after this procedure.

It is also important to know that the areola scar will always be noticeable (some more than others). This may be because the scar heals with too much or too little pigment or because the scar is raised. You should also be aware, that areola reduction surgery does carry other risks such as spreading of the areola, asymmetry, shape irregularity etc. in order to avoid disappointment, it behooves you to be aware of the worse case scenario and, armed with that  information decide whether to proceed with the procedure, or not.

Make sure you are evaluated by a well trained/experienced board-certified plastic surgeon (and see many examples of his/her work) to maximize your chances of a successful results.

Best wishes.

Different options in areola reduction

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Patients today have many different options in the reduction of the areola. The most important first step is to determine if this is all that the patient needs to create a pleasing breast shape and appearance. In many patients, the large areola may also be a component of an abnormally shaped breast caused from tuberous breast deformity or natural sagging of the breast. Your plastic surgeon will be able to review your options and help you decide which procedures will create a balanced and beautiful breast shape and appearance.

The procedure is relatively straight forward

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The procedure is relatively straight forward but when your areola are this wide, you may have a tuberous or constricted breast, especially if you have not had children.

Also, if your breasts are large, the proportionality has to be kept in mind to.

I would recommend that you visit with a board-certified plastic surgeon so they can examine you and go over your options.

Dr Edwards

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.