Asymmetrical areolas. What is the best approach to fix this? (photos)

Thanks for your question and the photo. The asymmetry that you are concerned about (areolar position and vein protrusion) is not uncommon. Despite measuring everything, breasts can heal differently. The Nipple-IMF distance is longer on the right and that can be corrected with an excision of an ellipse of skin inferiorly. This will bring the nipple-areolar complex down. It will not move it more medially however. I don't see this asymmetry to be that pronounced. Revision surgery is never a 100% guarantee so I'd make sure that you discuss the risks/benefits with your surgeon prior to committing. Find a Board Certified Plastic Surgeon in your area that is an ASAPS member and specializes in aesthetic breast procedures. The Smart Beauty Guide is an excellent resource. Best of Luck!

Your asymmetry is relatively mild in terms of the areolas themselves. Your lower pole on one breast looks longer which may make the areola on that side appear higher than it actually is. If there is excess skin in the lower pole of that breast, the treatment may include removing some more skin along the horizontal fold portion of your scar. Moving areolas left-right is usually a bad idea and can be difficult as it is hard to hide the evidence of the where the areola used to sit without leaving a scar. Raising a low areola is usually easier because the scar sits below the areola (in addition to the scar around it), which hides it better since you already have a scar there from the prior lift. A narrow areola is easier to improve by stretching and/or tattooing the difference as opposed to reducing a wide areola which if not done carefully (and even when done very carefully sometimes still) can result in stretching of the scar and/or the areola again. Exam in the office is the best way to tell which factors are influencing the visible asymmetry and to plan a proper correction.

Thank you for reaching out and posting a photo. Asymmetry is normal, as no one is perfect! But it is a fairly easy fix, I would suggest you reach out to your surgeon and ask about a small revision. Best of luck! Dr. Kachenmeister

Potentially this can be a relatively easy fix. There is much more skin below the right areola as compared to the left side. The distance is elongated. Therefore, by excising an ellipse of skin along the crease which can encompass the previous mastopexy scar, the areola can be brought down, the shape improved and greater symmetry obtained. An examination would better determined if anything else needs to be done positively address your result.Steven Turkeltaub, MD

Thank you for your question. Yes, this can easily be fixed by excising some skin along the intramammary fold and lowering the nipple areola complex that is higher. Overall, however, it is normal to have some slight asymmetries between the two breasts. Sometimes this is something that patients wait to fix until they need their implants exchanged; other times they wish to do it sooner. Depending on the amount of tissue that needs to be excised, this can potentially be done under local - but your best bet is to be examined by an American Board-Certified Plastic Surgeon in person to find out all of your options. Best of luck!