Areola reduction is surgery that reduces the diameter of an enlarged areola to bring it into proportion with the breast.
The right diameter for the areola differs with the size and shape of the breast. When the areola widens and stretches through pregnancy and breastfeeding, weight changes, or the sagging or enlargement of the breast tissue, the whole breast can look droopy or out of proportion. Areola reduction is surgery that removes a ring of skin from the outer edge of the enlarged areola and closes it to reduce the diameter.
The goal is not simply to make it smaller, but to set a diameter that suits the volume of the breast and the position of the nipple. Reducing the areola too much can make the breast look larger or unnatural, and the wider the ring removed, the more tension falls on the suture line and the more the scar may widen.
At Atelier Plastic Surgery, we measure the diameter of the areola together with the width of the breast and the position of the nipple to set the target diameter, and design the incision so that the suture line is concealed by the color difference at the border of the areola. Because it is often combined with a breast lift or breast augmentation, when done together we plan around the final shape of the breast.
After the target diameter is set, the areola skin outside it is removed in a doughnut shape, and the outer skin is gathered inward and sutured. The incision line sits at the border between the areola and the skin, where the color difference conceals it.
After the excision, a purse-string suture with a thread that does not stretch easily is added around the areola to spread the tension on the suture line. Its purpose is to reduce re-widening of the areola and spreading of the scar over time.
When an enlarged areola comes with sagging, the size of the areola and the position of the nipple are corrected together through the same incision line as a periareolar lift. Depending on the degree of sagging, a vertical incision may be added.
When the volume of the breast increases with an implant or fat grafting, the appropriate areola diameter changes as well. When the areola protrudes, as in tuberous breast, the areola is reduced while the tissue beneath it is reshaped.
Surgical designs and results are drawings based on photos; results vary by individual.
These may vary depending on your condition; we will give you precise details at your consultation.
The right areola diameter is not a fixed number; it depends on the width and volume of the breast. At consultation we measure breast width, nipple position and the difference between the two sides, and set a diameter that suits the breast together with you.
The wider the ring removed, the more tension falls on the suture line, and the scar may widen or the areola may spread again. When the excision is wide, we add a purse-string suture and, if needed, combine it with a lift to share the tension.
The areola and the surrounding skin differ in color, so a suture line placed at that border is relatively inconspicuous. We mark the incision so that it follows the border precisely and close it in layers so the suture line does not become uneven.
When the ring around the areola is removed, the dissection is kept at a depth that does not damage the blood supply and sensory nerves to the nipple. The larger the excision, the more this matters, so we prioritize a conservative extent over an excessive reduction.
After surgery, a dressing is applied to the areola and you go home. On the day, avoid pressure on the chest and avoid raising your arms high.
There may be swelling, bruising and a pulling feeling at the suture line. Take the prescribed medication and check the condition of the dressing.
You visit to have the wound checked. Depending on the wound, showering becomes possible; take care not to rub the areola.
Stitches are removed. Much of the swelling has subsided and light daily activities are possible. Wear comfortable underwear without underwire.
The suture line looks red during this period. Scar care begins, and strenuous exercise is started after this point depending on your condition.
The swelling resolves and the shape and diameter of the areola settle. The redness of the suture line fades, and aftercare such as scar laser is provided if needed.
After areola reduction, bleeding, infection, separation of the suture line, swelling and bruising may occur. The suture line around the areola may widen or become red and thick over time, and the wider the excision, the higher the likelihood. The areola may widen again or become oval over time, and in some cases the thread used for the purse-string suture can be felt or show through. Sensation in the nipple and areola may become dull or overly sensitive; asymmetry of diameter or shape between the two sides, irregularity in the color of the areola border and, rarely, tissue damage to the nipple and areola from reduced blood flow may occur. Revision surgery may be needed depending on the result, outcomes vary by individual, and we explain everything fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Nipple reduction that looks at length and width separately
Learn more Related Breast liftA breast lift with the incision pattern chosen by the degree of sagging
Learn more Related Tuberous breastTuberous breast correction that addresses the narrow base and the high fold together
Learn more Related Nipple deformityNipple deformity correction with a method for each shape
Learn more Related Academic ActivityPapers · books · conference lectures and chairs · society positions · ORCID
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