I was wondering what the best approach is for fixing herniated areolas. I have tuberous breasts and though the shape of my breasts bother me, my herniated areolas bother me most. I was wondering if scoring the bottom breast tissue is enough to fix my tuberous breast shape and remove the herniation of my areolas? Or is it necessary for me to have my breast skin stretched out and have the really ugly circumareolar incision/scar that seems to accompany that method?
Removing Areolar Herniation? (photo)
Doctor Answers 9
Circumareolar lift is best approach for correcting herniated nipples.
Thank you for your question and the photos.
Yes, a circumareolar lift is best approach for correcting herniated nipples, and breast implants can fill the absence of volume in the lower half of your breasts. There are techniques that can be done to prevent widening of the circumareolar scars.
To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.
Treatment of areolar herniation
For tuberous breasts, scoring the breast tissue will allow the constricted breast tissue to spread out more evenly over an implant, but the periareolar excision will be necessary to correct the areolar herniation. This technique also helps a pointy breast to look more natural.
Areola herniation and tuberous breasts
Scoring the internal tissue only, without correcting the areola with a circumareolar approach, would not likely do too much to correct a herniated appearance, and wouldn't allow for reduction in the diameter. In fact, it might make the diameter larger. Lowering the fold and placing implants are other key manuevers to create a better-proportioned breast for those with tuberous breasts.
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How to improve breasts? (photos)
You have a light complexion, good symmetry, and small breasts with high inframammary creases, in addition to areolar issue referenced. Your body is very well shaped, and if you're getting a circumareolar scar to fix areolae, that scar should be used to lower your inframammary creases and insert implants to improve (normalize) breast size and shape. Fixing the areolae is an afterthought. Find a good surgeon, you'll look fantastic. Scars are obscure, nearly invisible as time passes, and if they bother you, are easy to revise.
Preventing areolar scar from stretching
A circumareolar incision with the subareolar technique is best to avoid scar stretching.
The sub-areolar technique utilizes multiple deep sutures that take tension off the skin incision,thus reducing the herniated tissue and improving the scar
Although it is difficult to tell for sure from your pictures, I think an implant alone may make your breasts look more normal and in proportion. Part of the reason your areolae look so prominent is that they are proportionately too large for the amount of breast tissue you have. With an increase in the breast size, the areolae may "match" better and this couldbe done without the circumferential areolar scar. And it it does not correct the imbalance to the point where the areolae are still too prominent, you can always then have a circumareolar reduction. That would be two surgeries, but I think there is a good chance you would not need the second one. You should see a plastic surgeon certified by the American Board of Plastic Surgery to discuss your concerns and options. Good luck.
Fixing areolar herniation for tuberous breasts
Thank you for the photos. There are several answers about correcting your deformity and all of them suggest implants and tissue rearrangement. I propose fat transfer to the breasts to create a better shape and correct your herniated areolae. This procedure does not leave any scars and you have enough fat around your midsection to give you a very pleasing result. Find a plastic surgeon who is familiar with this technique. Good luck.
Your puffy nipples will almost certainly require a circumareolar incisions for their correction. You don't necessarily require a breast augmentation unless you really want to be bigger. If so, the implants can easily be inserted via the same route. Your high infra-mammary folds may have to be lowered, otherwise the implants will seem unnaturally high.
Correction of tuberous areola shape
I have been correcting the areolar breast shape that you have for years, but know of no technique that wouldn't leave you without a circular scar pattern. The scar pattern has to be used, but if you were fortunate the scar may stay narrow and hopefully not spread out at all. Ask your chosen Plastic Surgeon how th scar may be limited in width and not spread out
Good luck to you.
Frank Rieger M.D. Tampa Plastic Surgeon
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