Decrease the Size of Areola Without Mastopexy?

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

Thank you for your question.
Yes, you can reduce the size of your areolas without a mastopexy (breast lift). This can be done through a procedure known as areola reduction surgery. During this procedure, excess skin around the areola is removed to make it smaller and more proportionate to the rest of the breast.
The surgery typically involves a circular incision around the areola, where the surgeon removes a portion of the surrounding skin and tightens the area with sutures. This procedure can even be performed under local anesthesia or with sedation, and the recovery time is usually short, often with minimal scarring that fades over time.
However, there are some considerations to keep in mind:
Scar: There will be a scar around the areola, which is usually well-hidden by the pigmentation, but it's permanent and cannot be completely removed.
Limitations: There is a limit to how much the areola can be reduced, and in some cases, reducing it too much can affect the appearance of the breast.
Pregnancy: If you plan on having children in the future, keep in mind that pregnancy can cause your areolas to stretch again, potentially requiring additional surgery later.
It is important to consult with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

If you are only concerned about the shape of your areolae, then areola reduction surgery may be a suitable option for you. This would reshape/resize the areolae to make them proportionately pleasing.

In your case since you do not have very large breasts that are heavy, you may be a good candidate for areolar reduction.  However, you need to understand that doing this procedure in breasts like yours is a type of mastopexy. It’s just that the incision is circular rather than lollipop or anchor-shaped.  It would give you a lovely result for a while. After a certain period of time, or with changes in weight or pregnancy, the areolas are likely to widen again. 
In your case, there is also a limit to how small they can be made.  If you want them much smaller, there is no way to do this without additional incisions being made where more of the pigmented skin could be taken. 

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 

Thanks for your question and pictures! Areola reduction can easily be performed alone under local anesthesia in the office. The scar is usually well hidden, because of the color change between areola skin and chest skin. If a large amount of areolar reduction is needed there can be a flattening of the front of the breast and temporary wrinkling of the scar. Best of Luck!

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 . . .

It is possible to reduce the size of your areola without a lift. To determine if you are a suitable candidate please consult with a board certified plastic surgeon. Best of luck.

I would caution you and advise you to think carefully.  Your breasts are well shaped and have no ptosis (droop). Yes you have larger than average areola, but still well within the normal range of what I see on a regular basis.  The reason I say that is that plastic surgery is all about weighing pros and cons.  You could have your areola reduced but you would get a scar extending all the way around your areola.  This typically is a good area to hide a scar but not everyone heals the same.  Also, the more you reduce the areola the greater the scar tension; which can lead to more visible scarring. Additionally the more your areola is reduced the flatter your breast will become.   If a patient presented to me with your concerns we would have a very honest discussion about the trade offs.  In this case you trade a nice shaped perky breast with moderately sized areola and no scars for a flatter breast with scars and smaller areola.

Yes you can have a areolar reduction now and wait for a lift later after pregnancy. The future lift (mastopexy) would use the same scars to further reduce the areola if stretched by pregnancy. The other option of course is to wait to do both surgeries until you have finished having kids.

I believe that you are a good candidate. Most areola reductions are done in conjunction with a mastopexy and/or implant placement. But if you just wanted the size of your areolas reduced, this can certainly be done. This involves determining the size of areola that you want and marking it with a marker before surgery. The areola skin outside of the circular marking would be removed. I would then place a permanent suture like a GoreTex suture under the skin to maintain the new size of the areola. If this suture is not placed, the new areola will stretch out to its previous size. I hope this information helps. Please consult with a board-certified plastic surgeon.