Would anatomic implants without areola reduction surgery look good? (Photos)

Question

I'm getting surgery in 3 weeks and now im reconsidering if I should keep my nipples as they are. My surgeon says I could not achieve the look I want without an aerola reduction surgery but I don't like how unnatural the nipple looks after the surgery. I've been told by another surgeon I can just place the implant and later in the future I can get the aerola reduction with local anesthesia if I'd like to. I like puffy nipples but maybe they're too big to look good.

Gary M. Horndeski, MD · Answer

Your breasts are widely separated and you have herniated nipples. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

The areolar reduction will mainly help correct the herniated areolae but there will be scars all the way around. Of course you can just get implants first. A later areolar reduction could be done later under local anesthesia

Gerald Minniti, MD, FACS · Answer

The other surgeon is right. First have implants placed and heal. If you want a areolar reduction later then it will have less skin tension and form a better scar. Simultaneous augmentation and areolar reduction can lead to bad scarring that is difficult to fix.

Steve Laverson, MD, FACS · Answer

In the end, it's your body and you must choose treatment that you're comfortable with.  Your surgeon has fulfilled his/her/their informed consent responsibility by warning you that your result may be disappointing without areola and peri-areolar skin tightening, which is quite true.  It's also true that areola reduction and peri-areola skin tightening can be performed later if desired.  Your breasts are tuberous and your augmentation is among the most demanding because of tight lower breast skin and fibrous bands that must be carefully managed to achieve the naturally beautiful breast shape you want.

Daniel Barrett, MD · Answer

Dear Generous105144,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. 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

Douglas Taranow, DO, FACOS · Answer

You have tubular breasts with puffy nipple/areolas, along with a constricted lower pole of both breasts.
While you could certainly do the breast augmentation, you may require a periareola (around the nipple) adjustment later if desired.
Dr. Taranow

Richard P. Rand, MD, FACS (retired) · Answer

Anatomic or round implants are not the issue and rounds are better almost always. You would benefit from areolar reduction but that can always be done later if you don't like the outcome with just implants. Make sure the implants have the proper diameter to get some cleavage.