What are the odds that the areola will stretch out again if a permanent stitch is not used?

Question

What are the odds that the areola will stretch out again if a permanent stitch is not used? Would it be worth doing this surgery? Alternatively, would making the breasts bigger help the areolas look more proportional (mine are about 2 inches in diameter)?

Ronald J. Edelson, MD · Answer

Areola reduction surgery is fraught with trouble. I highly advise against it. It’s not worth the scar and it’s hard to get them perfect m. Don’t bother

Raffy Karamanoukian, MD, FACS · Answer

There is a very good chance that you will have the areola stretch after surgery regardless of whether you have a permanent stitch or not. I would suggest a vertical limb or scar treatments after surgery. Our recommendation is Sequel Scar Defense gel and Sequel Dark Scar Corrector followed by pdl and fractional erbium.

Best,
Dr. Karamanoukian

Best, 
Dr. Karamanoukian

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question. Typically, when closing an incision, absorbable sutures are used under the skin to achieve a good structure, and take tension off of the outer most part of the skin, (epithelium). When performing an areola reduction, we typically will place a purse string suture in the dermis layer around the Nipple Areolar Complex (NAC). This suture is made of permanent material, (nylon, prolene, gortex). This keeps the tension down, and should keep the NAC from spreading. Usually this suture stays buried under the skin. Rarely, the knot might poke out, and so the suture may need to be taken out. We try and wait at least 6 months before taking the suture out. Most women want the NAC to be about 4 cm in diameter. Placing larger implants will sometimes make the areola larger as the skin gets stretched a bit, (depending on the size of the implants and your breasts). Best to talk with your Board Certified Plastic Surgeon. Together you will make a plan.

Jeffrey J. Roth, M.D., F.A.C.S.

Board Certified Plastic Surgeon

Las Vegas Plastic Surgery

Jeffrey J. Roth, M.D., F.A.C.S.

Board Certified Plastic Surgeon

Las Vegas Plastic Surgery

Gerald Minniti, MD, FACS · Answer

With or without an internal blocking stitch, your areola will re-expand. You provide no photos so that's all that can be said. Other techniques may be available to you that would can create long lasting and fine scarring areolar reduction (a formal breast lift).

Camille Cash, MD · Answer

There is a risk whether permanent sutures are used or not that the areola can stretch again even after surgical reduction.  This can happen for many reasons but often is related to tension on the incision.  This can be related to factors such as implants, size/weight of the breasts, or when too much tissue is removed.  It's best to visit with a board certified plastic surgeon near you for an evaluation to determine if you are a good candidate.

Connie Hiers, MD, FACS · Answer

The breasts will not change in size with the areolae reduction, but the proportion of non-areolar skin to areolae can be improved. Doing an areolar reduction only is more successful than when implants are added at the same time. However, the areolar skin is the most stretchy of breast skin and some do stretch again.

What are the odds that the areola will stretch out again if a permanent stitch is not used?

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