Hello, and thank you for your question regarding very puffy areolas and whether this is normal. A physical examination is warranted, and a more thorough medical history is also essential. However, from your limited pictures, most plastic surgeons would agree that you have a condition called tuberous breast deformity. A tuberous breast has a narrow base and an elongated breast. This can also lead to large areolas. Often, there is breast and areolar asymmetry. Treatment depends on what you’re looking to achieve with breast surgery. Most patients with tuberous breast deformity elect for breast augmentation and areolar reduction, and possibly even breast lift (mastopexy). During the breast implant insertion, it is essential to widen the base of the breast. This is accomplished through a procedure called radial scoring of the breast base. Some plastic surgeons stage these procedures to minimize complications. However, most plastic surgeons perform this as a combined surgery, with the insertion of the breast implant, radial scoring, and areolar reduction all performed in a single surgery. There is a moderate likelihood of requiring revisional surgery, depending on the case’s complexity. Most plastic surgeons would suggest you need to be completely developed before embarking upon reconstructive surgery for a tuberous breast deformity. Tuberous breast deformity treatment timing will depend on other features of puberty. Therefore, it will be important for you to consult with a board-certified plastic surgeon and possibly even an endocrinologist to ensure that the breasts have fully developed. Thank you for your question regarding very puffy areolas and whether this is normal. Good luck. Most plastic surgeons offer complimentary virtual or in-person consultations. Therefore, explore what other plastic surgeons have to say. If you cannot find an experienced plastic surgeon in your area, consider traveling to another state for specialized care. Sincerely, Dr. Katzen. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)
