My areolas are large and puffy and I’m wondering if getting implants would only make them larger and more protruding? (photos)

Question

I was recommended an areolar mastopexy however I am worried about the scarring and may just end up being more insecure about them than I already am. I have yet to find any before and afters that are similar to my own so I just don’t know how my areolas and nipples will look post-augmentation. I really want implants but worry that without getting my areolas done, they will only look worse.

Ronald J. Edelson, MD · Answer

I would more term your areolae as herniated.  This can be improved a few different ways but they would all involve scars around the areolae.  The lollipop lift is a good option combined with the implants because it prevents your areolae from getting stretched out again.

Farbod Esmailian, MD · Answer

You have a couple of options:1) Perform breast augmentation as well as donut (circumareolar) mastopexy to reduce the protrusion and size of the areola.  The scar will go all the way around the areola.2) Perform breast augmentation thru a periareolar incision without the mastopexy and see how things look at 4 months.  Since your breast will also be bigger with the augmentation, you may be just proportioned so as to balance things out and you may avoid the incision going all the way around.  If come 4 months down the line and the areola you fell is still protruding too much and too large, then the reduction can be done.  This is easy enough that it can be done in the office under local anesthesia.Hope that helps.

Urmen Desai, MD, MPH, FACS · Answer

Yes, there is a risk of this occurin.  I recommend re-evaluating after the implants and considering an areola reduction at that point. I also recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Bryson G. Richards, MD · Answer

An areola reduction to reduce the size (circumference) of your areola can be done at the time of the breast augmentation. Another option is to undergo the breast augmentation, and wait and see what happens to the areola. If they stay the same size, then you can avoid the areola reduction. The procedure can be staged.I hope this helps.- Dr Bryson Richards (Las Vegas Plastic Surgeon)

Daniel Barrett, MD · Answer

Dear Keeks19,this can be addressed during breast augmentation surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Curtis Wong, MD · Answer

but as your tissue stretches, it is possible the areola will become less puffy and nipple less projecting.  If concerns continue then, procedures can be recommended depending on what your goals are.  A doughnut mastopexy could be done at the proper time after your implants have settled and your surgeon can precisely position your nipples and get the best chance at being level post-op but this procedure also has potential for poor scarring, flattening of projection (which is kinda what you want here), and a palpable suture at the edge of the areola.So focus more on implants if you want to be larger or consider doing nothing if you're comfortable with what you have at this time...they are still pretty and without any scars.

Adolfo Sesto, MD · Answer

Hi. No need to worry about the areolas  since they will also be corrected in the same procedure when placing the implants, with the same incision using the Periareolar Technique.International Member of the American Society of Plastic Surgeons (ASPS)
Dominican Board Certified Plastic and Reconstructive Surgeon
Member of the International Society of Aesthetic Plastic Surgery (ISAPS)

Johnson C. Lee, MD · Answer

Thank you for your photos. It is quite possible that adding implants to your breasts may cause your areolas to become more prominent and noticeable, particularly in tight clothing. One way to correct this is to use an incision around the areola to resize and correct the puffiness. You are also correct that you will have a scar around the areola although the scars usually heal quite well. The choice is yours but it will not be possible to reduce the puffy areolas without an incision around them. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Robert M. Kachenmeister, MD · Answer

Thanks so much for reaching out and sharing photos. There are definitely a few options for you, I would suggest you start by going on a few in person consultations with experienced board certified surgeons. During your exam, the surgeon can go over all of the options with you as well as end result goals and expectations. Best of luck! Dr. Kachenmeister

Robert A. Hardesty, MD, FACS - Account Suspended · Answer

Dear Ms. Keeks19,
Thank you for your questions and photos. Without  actual exam I can only give you general advice which I hope you will find helpful.Yes, breast augmentation usually will usually expand the size of nipple areolaer complex (NAC), especially after having had children. Based solely on your photos you would benefit from a circumferential periareolar mastopexy (lift). 
Unfortunately it is impossible to perform surgery without making incisions that always results in a scar. The job of the  Plastic Surgeon is to minimize the scar using precise technique, gentle handling of the tissue, a scar prevention program and being abel to treat with lasers and injections if need be after surgery. 
Shape of your areolae and scars are two different topics but interrelated. The final shape of the areolae depends on the technique used and how your skins adapts (stretches). Since the NAC stretches the final scar appearance  is variable but usually good. 
The scar quality is mostly genetic (how your body heals) assuming a precise and gentle suturing technique is used.
We can decrease the amount of scarring in the post operative peroid which can affect the final appearance:
A)Embrace- a device we put incisions several days after surgery. Please go to their web site.
B)silicone gel sheeting (new gel is one of several brands)
C)pressure
D)massage
E) lasers
F) steroid injections 
G) rarely superficial radiation (for recalcitrant keloids).
I suggest you write down your questions and bring with you several model photos of the areolae shape and size you like and then make several different consultative appointments with experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and who are ideally members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
My best wishes, 
R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
Awardee: RealSelf Top 100
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

My areolas are large and puffy and I’m wondering if getting implants would only make them larger and more protruding? (photos)

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