Breast Augmentation with Areola Reduction

Breast augmentation has consistently been the most popular cosmetic surgical procedure for at least the last 10 years. According to the American Society for Plastic Surgeons (ASPS), more than 286,000 breast augmentation cosmetic surgical procedures were performed. For further comparison, 212,500 breast augmentation procedures were performed in 2000. It would seem to be obvious from these figures that each patient who undergoes a breast augmentation procedure has a very specific set of goals in mind for her outcome.

However, in some cases, patients may wish to undergo more than one cosmetic surgical procedure at the same time. A good example of this is a combination of a breast augmentation with an areola (the darkened skin surrounding the nipple) reduction. Women with small breasts and oversized areolas may feel as though the areola and nipple structure takes up the vast proportion of the breast and looks unnatural. This is often the reason such patients come for a consult with Drs. Crawford and Bailey.

Causes for Enlarged Areola

There are a number of reasons why women have enlarged areolas. In some cases, it is simply hereditary. More common causes include pregnancy and nursing, aging, hormonal changes, and certain medications such as birth control pills. More serious causes can include breast cancer, particularly if the areolas have changed shape or size suddenly.

Breast Augmentation Procedure

In a breast augmentation procedure, silicone or saline breast implants are placed into a special pocket that Dr. Crawford or Dr. Bailey will create as part of the surgical procedure. Implants are placed either directly in front of the muscle (subglandular placement) or behind the pectoral chest muscles (subpectoral placement). Although either saline or silicone implants are suitable for a combination breast augmentation and areola reduction, Drs. Crawford and Bailey recommend silicone implants, which are less likely to show any ripples or deformities in the implants themselves.

Areola Reduction Procedure

In an areola reduction procedure, Dr. Crawford or Dr. Bailey will make a series of small incisions around the areola. Excess areola tissue is removed, and then the sutures are placed to pull the areola tight, so that it is smaller. In some cases, the entire areola and nipple structure will have to be moved higher on the breast in order to look more natural with the breast implants.

Most patients recover quite quickly and can return to most normal activities such as work or school, driving, and taking a shower or bath, within a day or two following the procedure. Drs. Crawford and Bailey caution patients to wait three to four weeks before resuming any strenuous activity such as exercise, and that it may take as long as a few months for any scars from the procedure to fully fade. Patients may notice a change in nipple sensation, but this will usually fade by three to four weeks after the surgical procedure. Patients should also be aware that the areolas may stretch again due to aging.

Drs. Crawford and Bailey believe that the best way to approach breast augmentation is to provide breasts that look and feel as natural as possible. In some cases, this may include an areola reduction.