Is an areola reduction the only option? (Photo)

Question

44 years old, 5 months post donut lift and breast augmentation. A few days after surgery I developed blisters around the stitches. I was expecting the skin to stretch a bit, but I didn’t know about the uneven pigmentation in the areola. Is an areola reduction the only option now? If so, how does that affect the implants? How long would I have to wait for that procedure? Because of the history of blisters, is it something that could happen again? Thank you!

David Branch, MD · Answer

Thank you for your question.  The pigmentation may still change as things continue to heal-which takes 1 year.  If hyperpigmentation persists, areola reduction my be an option.  It is possible that you were allergic to the suture used, so I recommend you request different suture.  Keep in mind that there is still risk of uneven pigmentation even if you did not have a blister reaction.  Hope this helps.

Daniel Barrett, MD · Answer

Dear mgat5, 
it is hard to tell for sure without an examination. Sometimes tattoo can help with pigmentation issues. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You could have a revision now and use pullout or dissolvable sutures below the skin so that the stitch marks are not visible.

Camille Cash, MD · Answer

You can consider tattooing to better blend the pigmentation of the areola.  Speak with your surgeon about medical tattooing.  This would correct your concern without the need for further surgery.

Daniel P. Markmann, MD · Answer

Thank you for including a picture.  However, I'm not clear as to what it is that you're trying to fix.  Is it just the loss of pigmentation, the stitch marks, did your areola stretch out more than your liking?    If it is just the pigmentation, the best option is a good tattoo artist.   If your areola is too big, or if you're looking to get rid of the stitch marks, I would do the areolar reduction, but I would add a verticle scar to help prevent it from stretching again.

Mats Hagstrom, MD (license on probation) · Answer

Personally, I’m not a big fan of the donut breast lift for all of the complications that comes with the procedure.
Your outcome is a perfect example of why I don’t like this technique.
To make an assessment regarding the outcome of any plastic surgery procedure we need to see a proper set of before and after pictures.
 This include what the entire breast looks like because that impacts our understanding of how you can best be treated.
We need to understand the indication for the breast lift in the first place.
Having the same procedure done twice is unlikely to give you a better outcome.
Converting the procedure to a more proper breast lift is probably going to be a better option.
Whether that is justified or not is something you need to discuss with a provider.
If you’re confident with your current provider, then continue seeking advice from them.
If you don’t have faith in your current provider, then get second opinion consultations from other plastic surgeons in your community.
I suggest you rely exclusively on in person consultations, avoiding virtual consultations.
 For second opinion consultations come prepared with a complete set of proper before and after pictures and copies of your previous operative report.
These are part of your medical record that you can request at any time from your current providers office.
Best,
Mats Hagstrom MD

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