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Understanding Areola Reduction Surgery

Understanding Areola Reduction Surgery

Areola reduction surgery is an elective surgery chosen by both men and women who wish to reduce the diameter of the areolas. This is the darkened area of skin surrounding the nipple, which can change over time and grow both larger and darker due to such events as pregnancy, breast-feeding, weight gain or breast augmentation surgery.

Areola reduction surgery may also include lifting of the areolas to a higher position on the breast, which makes the procedure a little more complicated. Plastic surgeons use various methods to reduce the areolas, and each has a preferred type of surgery, incision and suturing.

Techniques Used

Incisions include a cut above the areola, around the bottom, and one that is place vertically through the bottom of the areola. If the areolas are being moved higher, the technique used will be a peri-areolar incision. This technique can also be used for a basic areola reduction surgery, but in this case the surgeon will remove some of the tissue above the areola and suture it in the higher position.

The sutures used for any of the procedures may be a permanent type or a non-permanent external suture. This depends on the plastic surgeon’s preferences as well as the specifics of each case. Permanent sutures, using a polypropylene material, are done in a star fashion that creates what is known as a drawstring or purse-string effect. This is meant to reduce the stretching of the scar tissue that can occur over time as the patient heals and the scar matures. There are some risks associated with this type of suture, including suture separation.

Some surgeons prefer a suture method that is non-permanent, but for very large, heavy breasts or people with implants this may result in stretching of the scar tissue in the future or as the incision heals. The right type of suture for you should be one of the many things you discuss with your surgeon prior to the procedure.

The Procedure

The areola reduction surgery itself is a relatively quick outpatient procedure that takes about an hour. It is performed under general anesthetic, and all patients should discuss the potential risks of this with their surgeon. Any time a person is put under anesthesia there is a potential for things to go wrong, but this is relatively rare.

The doctor will usually draw circles on the areolas either free-hand or using a stencil. Most prefer the stencil for accuracy. The surgeon will begin the incision and remove the extra areola tissue up the point of the drawn mark. When this is complete, the sutures will be placed.


Recovery time after the surgery is performed is generally fairly short for most patients. You should be back to work in a day or two after the surgery, but you can expect the long-term healing process to take quite a bit longer. By about 3-4 weeks after the surgery, you should be able to return to all normal activities including exercise. This depends on the patient, and you should discuss all activities you plan in the months following your surgery with your doctor.


Prior to any surgery, you should take the time to understand all of the risks and potential complications. In addition to the anesthetic risks, areola reduction surgery complications can include infection, pain or numbness at the site of the incision, sutures breaking and bleeding at the site. There can also be aesthetic problems such as asymmetry of the areolas and stretching of the scar tissue. Most areola reduction surgery goes smoothly, however, and the results are generally very good. Your particular experience will depend on many factors including the size of your breasts, shape of the areolas and the type of technique used.

Most patients who undergo areola reduction surgery recover quickly and suffer no long-term effects. Still, as will any surgery, you should be aware of all possible problems that could be encountered. Be sure to talk with your doctor about all your options and all of the risks of each procedure prior to making a decision. Be sure you have chosen a surgeon with a great deal of experience in the procedure and who takes the time to explain the process to you. With a good doctor and proper care, your areola reduction surgery will go smoothly.

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