Decrease the Size of Areola Without Mastopexy?

I am 21 years old, 135lbs, no pregnancies. I am very unhappy with the look and shape of my areolas. I want a smaller more youthful look, but would rather wait to get a mastopexy later, after pregnancy. Am I a good candidate for a nipple surgery procedure?

Doctor Answers 33

Areola reduction is possible, but do you really want scars now?

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Certainly you can have periareolar reduction, and careful technique can yield good results. But large areolas cannot be made too tiny, as the circumference of the present areola must be purse-stringed to the new smaller circumference. So there are limitations, and no surgeon, "special sutures," or surgical technique can ignore the rules of dimension. Too much discrepancy equals scar irregularity, with pleating or puckering that can lead to poor healing and a potentially wide or unsightly scar. What if you decide you don't like the scar, and in fact hate it worse than your present appearance? There is no going back, so I would advise caution. In fact, I might be so bold as to ask why you think your breasts, which appear very pretty in your photo, have a "poor look and shape" and make you want a "smaller and more youthful" look?

You are certainly entitled to feel any way you want about your body, but you may be overly sensitive about breasts that are not only perfectly normal, but really nicely full and extremely attractive for any woman. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Is a mastopexy needed here.

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This photgragh demonstrates enlarged areola and breast asymmetry .    Pregnancy does not always cause ptosis(droop) and you may never require a full  mastopexy.  Breast asymmetry  may also be contributing to your dissatisfaction with your areolar size and position.  The size of the areola can be adjusted with a permanent pursestring suture, however you may wish to address the other aspects of  asymmetry  as well. This should be throughly reviewed with your plastic surgeon. 

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.8 out of 5 stars 19 reviews

Areola Reduction

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You do have nicely shaped breast and definitely do not need a lift. There to reduce your areolas will be very simple procedure. It involves making the new areola marking, then remove the skin between the marking and the outter part of your areola now. Then a special suture is passed through and close the area, and now you will have a smaller areola. Hope that makes sense.

It can be done under local anesthesia and you would not need to be put to sleep.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Areola Reduction Now or Later

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The very best advice I can give you is to schedule consultations with at least two board certified plastic surgeons and weigh your options carefully.  I agree with what some of the other doctors have observed: your breasts are nicely shaped and proportioned.  And though your areolas may be somewhat larger than "average," they look normal on you.  Your breasts are good sized so the areolas look like a fit, and your areola skin is light in color.  We often work with patients whose areolas are much more "out of whack" than yours.

If you do want areola surgery now, of course it is possible.  A doughnut shaped ring around the outer edge can be removed so the diameter will be reduced.  The nature of your scars after healing is difficult to predict, however, and your areolas may stretch again with pregnancy or just through the aging process. 

These tradeoffs are exactly what you should discuss with a qualified plastic surgeon.  If you are really bothered by your areolas now, it may be a good idea to move forward.  But if you are indeed thinking of a mastopexy later in life, you may want to wait.

Elliot Jacobs, M.D.

New York Plastic Surgeon


Unhappy with areolas

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In my opinion, you have very pretty and naturally shaped breasts. Very little ptosis, good proportionate size and appropriately sized areolas. I would recommend no surgery until you are done with children if needed. Once you have a scar on your breast, there is no going back . . .

Joel Patrick Maier, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 33 reviews

Areolar reduction surgery

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As has been clearly stated, it is possible to have an areolar reduction without a mastopexy.  This is actually quite similar to a circumareolar mastopexy in technique and eventual scarring.  The outer diameter matches the border of your areola, the inner circle is centered around your nipple measuring a smaller diameter (around 40 mm). 

There are two trade-off's with this procedure

  1. The scar.  This is generally of good quality but can look a little like a bulls-eye around your nipple.
  2. There is a little flattening of the central breast.  Generally this improves significantly but may be a subtle permanent change.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 189 reviews

Areolar Reduction is possible

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Yes, if your areolae truly a concern to you, they can be reduced in diameter. You would have a scar going all the way around your areola to accomplish this. Although you certainly don't appear to need a mastopexy at this time, if in the future you did, you certainly could, even after a prior areolar reduction.I would also add that your areolae may stretch again during pregnancy -- I would advise to wait until after finishing all childbirth before pursuing this if you can wait.

Nirav Savalia, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 46 reviews

I do believe you can have areolar reduction alone.

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Consult with a board-certified plastic surgeon who has lots of experience in breast surgery. In our Santa Rosa, California plastic surgery practice we have performed areolar reduction alone in selected cases with excellent results. It means having a scar around the entire areola, but the areola can be reduced in diameter quite significantly.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Areola Reduction

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Thank you for your question.

Areola correction is a local anaesthetic procedure unless it’s combined with a more complex breast surgery that requires a general anaesthetic. Prior to surgery our plastic surgeons will assess you and your desire to achieve the look, shape, size and symmetry of what you are looking for.

On the day of your surgery our cosmetic surgeon will measure your breast height and various distances from your areola as well as the diameter of each. We make marks on your breasts while you are sitting upright and then numb the area with small amount of local anaesthetic.
Extra areola skin can be removed to achieve the desired look and position. The scars are very fine and heal quickly and fade over time. In some people the scar can be touched up with medical tattooing to hide the visible signs of a surgical scar.

Simple dressing is then applied before you are discharged from the clinic. You can resume daily showers and are expected to see your plastic surgeon in a week to check the wound.

Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.

All The Best 

Areaola can be reduced

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Your areolas can be reduced.  The surgery can be performed under local anesthesia and involves removing areola skin and suturing it your normal flesh colored skin.
A future pregnancy can alter this result and you could need it again.
Best wishes,
Dr. Denkler

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.