Wanting more symmetry with right breast. Would areola reduction be enough or would I need lift/aug? Happy with size. (Photo)

Question

Female, age 30. 70kg, 5ft 6. No plans to have children.

Wayne I. Yamahata, MD · Answer

Your symmetry would be improved, albeit not perfect, with an areolar reduction. Most would find the improvement adequate and allow you to avoid more extensive surgery. If you are happy with your size, there is no justifiable reason to add implants.

Donald R. Revis Jr, MD · Answer

Good evening,
I think an areola reduction would be a reasonable approach to achieve better symmetry- to me you do not need implants if you don't want them and you are happy with your current size!

Leila Kasrai, MD, FRCSC · Answer

If you are unhappy with the overall shape of your right breast in relation to symmetry with your left, then a breast lift is recommended. However, based on your photo and the info you’ve provided, it sounds like your only concern is your areola. For this reason, areola reduction on your right breast may be sufficient to achieve your goals.

Gary M. Horndeski, MD · Answer

If you are happy with your breast size then you do not need augmentation.  If you are unhappy with the areola then I recommend an areola revision only.

Best Wishes,

Gary Horndeski, M.D.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Your level of asymmetry is subtle but with not wanting to change your overall breast size, the areolar reduction would be the only procedure worth entertaining. Hope this helps.

Daniel Barrett, MD · Answer

Dear Nlhill1990,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ram Kalus, MD, FACS · Answer

My colleagues have answered well. Some breast asymmetry is entirely normal. Clearly you would not have posed your question if you were not bothered by your asymmetry. If the visual asymmetry of the areola is the principle source of concern the solution is fairly simple and can be performed under local anesthesia in the office setting. Please consult with a board certified plastic surgeon to discuss your options in more detail. Best of luck to you.

Robert M. Tornambe, MD · Answer

I appreciate your concern, however my first reaction after viewing your photo is the fact that you have very attractive, natural breasts with slight asymmetry, your right areola is just a bit larger than the left. Unless this really bothers you, I would recommend doing nothing! If this asymmetry is an issue for you, right areolar reduction is a simple solution and the scar should be reasonable as it will lie at the junction of the skin and the periphery of your areolar tissue. Consult with a board-certified plastic surgeon in your area to explore the best options for you. Good luck.

Heather Vande Ven, DO · Answer

Based on the photograph, it may help with the appearance of symmetry. Achieving symmetry in breast appearance depends on your specific situation. Areola reduction can help with symmetry if the size or shape of your areolas is a concern. However, if there’s a significant difference in the position, volume, or sagging of your breasts, you may need a breast lift, augmentation, or a combination of both. Consulting with a board-certified plastic surgeon is essential to determine the best approach based on your individual needs and goals.

Connie Hiers, MD, FACS · Answer

You could just try the areolar reduction on the one side to see if you are happy with those results.  There would still be a small difference between the two breasts, but most people would not even notice it.