Why are areolas always made circular in breast reductions?

The areola size and shape can be maintained in a breast reduction, if the patient desires that.  Many times the areola is very large, uneven, or lopsided and most patients want the areola size reduced. Typically your PS will cut a doughnut-shaped piece of tissue out of your areola where the scar can be more easily hidden and prevent stretching.

Dear milbow,Thank you for your question. Most nipples are made circular after a reduction or lift. This shape is the most common shape for nipples (circular or ovoid). Most nipples are not perfect circles but are circular in overall shape.Best regards,Nirmal R. Nathan, M.D.

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgeons
Real Self Hall of Fame

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Although the shape of the areola may be distorted as the breast fluctuates in size and shape, the areola naturally has a circular shape. This is why plastic surgeons create circular areolas. Best of luck!
Matthew A. DelMauro, M.D.

Hi and welcome to our forum!
The areola is naturally circular in shape. Areolar shape is affected by breast size and weight, ambient temperature, gravity, and sexual stimulation.  
At surgery, the circular shape is chosen usually between 38-42 mm in diameter) and is mapped with the patient in the supine position (where effects of gravity and position are minimized).  
After surgery, areolar shape will vary from circular when supine to oval when standing.
Best wishes...