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A large areola on the breast might be from genetics or hereditary or it could have come from a results of stretching of the tissue from weight gain, breast implants, pregnancy and breastfeeding. The procedures of a breast lift or a breast reduction usually incorporate this in conjunction of the actual surgery. But a simple areola reduction can be done by itself if the breast and the nipple are in good condition. An areola diameter on an average size breast (between a B and a C cup) is usually no larger than 4 to 5 centimeters. Smaller breasts do look aesthetically better with smaller areolas. And larger breasts look better with slightly larger areolas. This procedure can be done as an outpatient under just local or twilight anesthesia because the surgery itself only actually involves going skin deep. If the patient prefers to have general anesthesia for this procedure, then this can be used as well. This surgery is intended to remove the excess areola tissue. This will allow an improvement to the overall aesthetic appearance of the areola. Like with any surgeries to the breast, you will have some scarring, however the areola area normally heals exceptionally well. The reduction itself may give the breast mound an actual lift, however you need to be aware that some irregularities can occur at the incision line because of the purse string suture method and or if the reduction of the areola was significant.
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The surgery consists of the surgeon making two concentric circles on the actual areola complex, around the edges. This portion of tissue and epidermis is removed; however the area around the nipple is left undisturbed. A pedicle is left and internal purse string sutures are used to keep the areola from stretching. During the entire procedure the nipple is still attached to its blood supply and to the milk ducts. Sutures are used to close the incision and eventually with time, the scar will heal to a thin white line. The sutures usually remain for 7 – 10 days post operatively. Once the sutures are removed, you might see some puckering around the edges from the purse string method. Most of the time, this puckering/rippling will go away with time. This procedure is similar in a way to the Benelli Lift procedure, however with the actual Benelli, the surgeon is actually removing some of the breast tissue so that the areola will have a higher position on the breast mound. The surgery itself will leave a scar around the outer rim of the areola. Sometimes scars can cause “hypo-pigmentation" to occur, which is a loss of actual skin pigmentation. Some patients have used tattooing pigment to the lightened areas so that the scar will become camouflaged. Trying to use micro-pigmentation to areas involved with scar tissue can sometimes be problematic, as the pigment doesn’t want to take in those areas. However, an experienced micro-pigmentation specialist will be able to handle most cases successfully. Your surgeon will probably tell you to take things easy for a few weeks; and to refrain from picking up or moving anything more than 5 – 10 lbs. for the first 6 weeks. This is suggested so that the areola will not stretch back out again, and that you will have complete success with your repair. Areola reduction surgery is permanent solution to oversized areolas.
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