What Procedures Are Necessary to Fix my Areolas, Nipples and Shape of my Breasts? (photo)

I am 20 years old, 150 lbs and no pregnancies. I would like my areolas smaller and my nipples more prominent. They usually are flat against my breast and only come out when I am cold or turned on. I would also like to know what can be done with my breast shape. I do not want large circular breasts like implants give you. I would like natural looking breasts with almost a tear drop shape. All in all I just want to look natural. Thanks for all answers.

Doctor Answers 8

Tubular breasts

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Your photos show widely spaced breasts, a larger right than left breast, very large stretched out areolae and small nipples. It is a mild form of tubular breasts. Making the areolae smaller would involve cutting a donut rim around the edge. If you put an implant under that there is a high likelihood that the areolae will stretch again and/or the scar will be wide. I think you would be better off doing the areolae first with some fat grafting followed by a additional fat grafting 6 months apart. Then you will be less likely to stretch the scar or areolae.

The nipples could be made more prominent at the first surgery using small local skin flaps.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon

What Procedures R Necessary to Fix Areola and Breasts?Answr:

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I think a good starting point is with a per-areolar lift and augmentation...that will tighten up your wide areola and an implant will give you some more proportionate size...and this would help avoid the full lift as well....

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Breast surgery

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AS for reduction of the areola that could be accomplished.  It is not likely that you can have your nipples more prominent unless something is out under the nipple. As for volume,implant can enhance them.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

How to reduce large areolas and improve breast shape

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Thank you for the picture that accompanies your question. You have what is termed a tuberous breast deformity; this is defined by your large nipple/areola complex and the shape of your breasts. The best option for your breasts would be to reduce and lift your areola/nipples by removing skin and excess areola in a circular fashion at the edges. To improve the size and shape I would recommend either implants or a fat trasfer. A fat transfer would work well, but it would require you to wear a device pre-operatively that would expand your breast tissue and allow for room for the fat to be grafted to, if you are willing to commit the time and effort this would be your best option.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

To implant or not implant.....

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There are two issues that your bring up, your breast size and the breast shape. With regard to size, ultimately, if you want your breasts larger, most people utilize implants. Depending on the size of implants that you choose, they may have a rounder appearance. Another option may be fat transfers, especially if you want a smaller augmentation than could be achieved with implants.


WIth regard to your areolae, it looks like you would benefit from a reduction in diameter. This is accomplished wimassither a concentric or vertical mastopexy (breast lift). This does add some scarring but the shape improvement is typically worthwhile. I advise you to consult with a Plastic Surgeon to get a complete evaluation and assessment. 


Good luck

Lawrence Iteld, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Achieving your breast shape and size goals requires a consultation with a Plastic Surgeon

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Although your photos say a lot they are only part of the discussion required before recommendations can be made. For a more optimal breast shape with improved areolar proportions it is likely that an areolar reduction will be part of the solution. The volume, position and shape of your breasts will strongly influence the options and results that are possible. Changing the size of your breasts by adding an implant and changing the diameter and position of your areolae is possible but the specifics of how this should be done and what you will need to reconcile before proceeding needs to be done in person.

Good luck learning about your options when you attend a consultation or two.

Dr. Mosher

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 34 reviews

Breast shape and areola size

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From your photo, you appear to have mildly tuberous breasts of different sizes. You do not appear to to be ptotic (droopy). You should discuss with a board certified plastic surgeon the option of doing a concentric or doughnut Mastopexy to reduce the size of the areola. You already have a tear drop shape to the breasts. Implants wuld allow you to improve the breast volume symmetry. The look after implants is not entirely predictable. Some women look like two half grapefruits on their chest as you alluded, and some look more tear drop or natural. This depends on how your body heals the implant in place.

Todd C. Case, MD
Tucson Plastic Surgeon

Tuberous Breasts

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I recommend that you have a areola mastopexy with augmentation. I like to use adjustable implants when working on tuberous breasts. I believe it helps create better shape by adjusting the implants over a week or two. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.