Large areolas, inverted nipples and stretch marks. What are my options? I'm 23.

Question

I have always been VERY insecure about my large areolas, inverted nipples, and stretch marks. Along with losing 25+ lbs in the past two years, I also feel like they have started to sag too much for my age (23). I am not interested in implants however.

Daniel Barrett, MD · Answer

Dear nymphicana,
My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Caner Kacmaz, MD · Answer

Hi there, thank you for your question. If you are not interested in breast implants, then I can only suggest you to have areola reduction. You have a bit of sagginess as well but, it's minimal.

Casey Anderson, MD, FACS · Answer

Congrats on the weight loss. I would recommend a peri-areolar mastopexy - which means an incision around the areola to reduce the size. Special piercings can be done for the inverted nipples to cause a bit of scar that can help them not be inverted. Also some special plastic surgery techniques can be done that use your own tissue as a plug to help them stick out. As always, be sure to research who performs your surgery to ensure the best likelihood of a positive result.

Hanif Ukani, MD · Answer

It is possible to correct the size of the areolas with an areolar reduction. This is best done with a permanent internal stitch to mininmize the risk of it stretching out again.
The nipple inversion can also be corrected with surgery. This issue with this, however, is that during the surgery the milk ducts going into the nipple are often cut and this would eliminate the possibility of breast feeding in the future, so this would be better left until after you have kids.

Cormac Joyce, MB BCh, MBA, FRCS (Plast) · Answer

From your photos it does not appear that you have any sagging but it is hard to tell as you might have your hands above your head in the second photo. You would benefit from an areolar reduction using a permanent pursestring suture to prevent stretching. There are 2 main techniques - the first where the outer cicumference is excised leaving a scar around the areola. The second techniques involves excising a disc of areola from around the nipple so that the scar is left just around the nipple. The inverted nipples could be corrected at the same time.

Gary M. Horndeski, MD · Answer

The best option for you is a modified Benelli lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. The areolas can be reduced to the size your desire. At the same time, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Both can be addressed incorporating an areolar reduction procedure with an inverted nipple correction. Although the scarring from the inverted nipple correction is minimal, the areolar reduction is more noticeable and should be discussed in detail with you.

Donald R. Revis Jr, MD · Answer

Good evening!

The best way to reduce your areolas is with a donut mastopexy, which ,ay also be able to incorporate some of the stretch marks, without implants being placed!

Kenneth Hughes, MD · Answer

Hello, thank you for your question. Usually correction of the inverted nipples involve division of the lactiferous (milk ducts). Risks include potential loss of sensation, inability to breast-feed, recurrence of the inversion and the potential need for further surgery. Large areolas can be corrected at the same time. I recommend you to schedule an email or Skype consultation with a board certified plastic surgeon for proper evaluation.

Patrick W. Hsu, MD, FACS · Answer

Hello and thank you for sending in your inquiry. Based on the photos provided above, I would recommend undergoing an areolar reduction. There other options, such as fat grafting to the breasts that can provide you with very natural results. I suggest scheduling a consultation with a board-certified plastic surgeon to discuss your surgical options and your ideal results in greater detail. Best of luck to you!

Large areolas, inverted nipples and stretch marks. What are my options? I'm 23.

Answers (17)

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