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

From the submitted photo you appear to be a good candidate for the areola reduction. At this time a mastopexy is not needed. You can consider an areola reduction now and still get a mastopexy after pregnancy/breastfeeding if needed. See a board certified plastic surgeon near you to learn more.

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