Areola reduction procedures are options for both women and men who want to address enlargement of the pigmented areas of skin surrounding the nipples. Dr. Joseph A. Mele, our board-certified plastic surgeon, is skilled with a variety of advanced techniques that can be performed as standalone procedures or combined with other treatments in a customized treatment plan. If you have questions about areola reduction, or if you would like to schedule a confidential consultation with Dr. Mele to talk more about treatment options, please contact our practice today. 

What Is Areola Reduction? 

Areola reduction surgery reduces the circle of pigmented skin found around the nipple. It is performed for both men and women, often in conjunction with breast reduction, breast lift, gynecomastia reduction, nipple reduction, or inverted nipple correction procedures. The areola naturally enlarges, and may darken, in response to the hormones released during puberty and pregnancy. Often, the areolar enlargement seen during pregnancy remains, even after lactation ceases, and may persist even when the breasts lose volume. For men, a large areola is often associated with male breast enlargement (gynecomastia), and has a feminizing effect on the appearance of the breasts. Areola reduction can reduce the size of the large areolae and is often performed in the office under local anesthesia. The recovery period is typically relatively short. 

Areola Reduction Before-and-After Photos (Men & Women)

Results shown are specific to each patient and individual results will vary

Am I a Candidate for Areola Reduction? 

Candidates for areola reduction often feel their areolae are disproportionate for the size of their breasts. The ideal size for the areola is subjective. Proportion is important, so the diameter of the areola is dependent on the size of the breast mound. The average areola size is 42mm; however, personal preference varies.

For this, or any elective procedure, your safety comes first. You need to be in good health, and any health problems you may have need to be well controlled. If you were recently pregnant, it is best to wait a year after delivery to allow the areolae to shrink maximally. If you are breastfeeding, a minimum of  three months after milk production has stopped is recommended to prevent complications. 

How Does Female Areola Reduction Work?

Disproportionately large areolae (the plural of areola) can be a source of embarrassment for women. Whether the enlargement of the areolae is isolated or found in conjunction with large, sagging, or tubular breasts, areola reduction can be an important part of breast enhancement surgery.

Areola Reduction as a Solo Procedure

When performed by itself, areola reduction is a minor surgical procedure. It is often performed under local anesthesia; however, conscious sedation or general anesthesia may be desirable in certain situations. The nipple and central portion of the areola remain attached to the breast, and only the excess, peripheral areolar skin is removed. Since the pigment is contained in the superficial portion of the skin, only a thin layer is excised. Fine sutures are placed underneath the skin edges to re-approximate the areola to the surrounding skin. For large reductions, a restraining suture may be placed to help maintain the smaller areola’s circumference. A small breast lift is included with this approach, when it is desirable. The periareolar breast lift cannot substitute for a formal breast lift. If too much is asked of the procedure, the areola may stretch and become too large again. 

Areola Reduction with Breast Reduction

When large areolae are associated with heavy breasts that cause neck and back pain, areola reduction may be incorporated as a satisfying component of your breast reduction surgery (Reduction Mammoplasty). Breast reduction surgery is performed to reduce the volume of, and relieve the symptoms associated with, enlarged breasts. Not only will breast reduction reduce your breasts’ volume, it will also lift the breasts and reposition the nipple and areola higher on the breast mound. The nipple and areola remain attached to the breast tissue during most breast reductions, and reduction of the areola is very easy to include with no additional scars. 

Areola Reduction with Breast Lift

For patients scheduled for a breast lift, the enlarged areolae associated with saggy breasts can be corrected during your procedure. The incision necessary for your breast lift is also sufficient for areola reduction surgery. The areolae are reduced and repositioned, without being detached from the underlying breast tissue, thus preserving maximal circulation and sensation. 

Areola Reduction with Tubular Breasts

For patients with tubular breasts, areola reduction is an important part of the correction. Tubular breasts are often associated with enlarged and full areolae, as the breast tissue can herniate into the areolae, causing puffy nipples. By reducing the areola, the breast tissue is confined to the breast mound, and cannot over-inflate the areolae. The result is a less tubular, and more rounded, aesthetic breast mound.

If you are interested in learning more about areola reduction, call our office today at (925) 943-6353 to schedule a consultation. 

How Does Male Areola Reduction Work? 

Male areola reduction can be performed by itself or as part of another breast procedure. The most common breast procedure for men is gynecomastia surgery (male breast reduction). With gynecomastia, the areola is often enlarged. Areola reduction can reduce the overall size of the pigmented skin around the nipple, and provide a more masculine chest. When the nipple is large, nipple reduction may also be desirable. 

Areola Reduction as a Solo Procedure

As with female areola reduction, when performed by itself, male areola reduction is a minor surgical procedure. It can be performed under local anesthesia; however, conscious sedation or general anesthesia is also an option when desired. Since the pigment is contained in the superficial portion of the skin, only a thin upper layer of skin needs to be excised. Once this excess peripheral pigmented areola skin is removed, fine sutures are placed to inset the new smaller areola into the surrounding skin. A restraining suture is rarely required for men. When the areola is full or projecting, gynecomastia reduction is performed concomitantly.

Areola Reduction with Gynecomastia Reduction

Areola reduction can be a component of gynecomastia reduction surgery. In cases where the areola is enlarged, reduction can provide a more masculine appearance. The male areolae are smaller, lower, more lateral, and more oval than the female areolae. Careful attention to detail is required for optimal results. The periareolar incision used for the areola reduction can also provide access for removal of the enlarged male breast tissue. By removing the excess tissue, the areola is flattened. 

How Should I Prepare for Areola Reduction Surgery?  

Areola reduction preparation includes the usual items found on any preoperative checklist. The most important step is an in-person consultation appointment to review your concerns, the details of areola reduction, and the expected outcome. The risks, benefits, recovery information, and any alternatives are reviewed so that your decision is an informed decision, and so that you feel comfortable before electing to proceed. Your health is reviewed and appropriate precautions are recommended. Avoiding medications, herbs, and supplements that increase your risk of bleeding is recommended. Be certain to discuss these with Dr. Mele prior to your procedure. 

What Can I Expect During Recovery from Areola Reduction Surgery? 

Areola reduction recovery is usually quick and uneventful. The surgical site is covered with Steri-Strips™ and these should remain in place until the doctor removes them. Bleeding should be minimal; however, gauze is placed into the bra just in case. Medication for pain is often prescribed, but over-the-counter medications like acetaminophen (Tylenol®), ice, and elevation are often enough. Acetaminophen should be taken instead of, rather than with, prescription pain medicines, because most prescription pain meds already contain acetaminophen. Showering is usually permitted 24 hours after the procedure, but the incisions should not be submerged until Dr. Mele tells you that your areola reduction is sufficiently healed. You will be seen in the office for routine follow-up visits, and additional treatments and instructions about scar minimization will be updated, as needed, during the healing process. 

How Noticeable Are the Scars from Areola Reduction? 

The appearance of areola reduction scars varies greatly. Most scars are smooth and flat, but some will be wide, some will be pigmented and some will be raised, making them more noticeable. Meticulous surgical technique and postoperative scar care can help, but how your body heals is often determined by genetics and cannot always be controlled.

For large reductions and when areola reduction is combined with a significant breast lift, a vertical scar is used to take some of the tension off the periareolar scar. This can help control scar width and give a better cosmetic result.

How Likely Is Loss of Nipple Sensation After Areola Reduction? 

Nipple sensation is usually preserved with areola reduction procedures. The nerve to the nipple comes from below and preserved. Changes in nipple sensation can occur and can lead to either increased or decreased sensation. In the cases when nipple sensation changes, the majority of the time, nipple sensation returns to normal after a few months. There are times when nipple sensation is lost and stays lost, and it is more likely the larger the reduction performed and the more stretch placed on the remaining areolar skin. A vertical scar can be used to reduce periareolar tension, and can help to preserve nipple sensation. 

Complementary Procedures 

Areola reduction is often combined with other cosmetic breast procedures. It is almost always done as part of a breast lift or breast reduction for women, and less frequently for men. If the nipple itself is enlarged, a nipple reduction can be added to reduce the projection or diameter of the central nipple. 

How Much Does Areola Reduction Cost? 

The cost for areola reduction varies. If you are having a breast lift or breast reduction for women, there is no additional charge for areola reduction. It is an integral part of the procedure. If you are only having areola reduction, the cost varies according to the time needed for the reduction and the type of anesthesia required. The time needed for reduction often depends on the technique required. Periareolar reductions are faster, while vertical lifts take more time. The anesthesia options include local only, local with IV sedation, and general anesthesia. 

Financing is also an option, and more information is available on our Plastic Surgery Financing page. If you are interested in areola reduction, an in-person consultation is needed in order to determine the best course of treatment and the specific price. A price range is available from Dr. Mele’s office. Call (925) 943-6353 to get the latest information. 

Schedule an Areola Reduction Consultation

If you are interested in learning more about our San Francisco Bay Area plastic surgery practice and areola reduction surgery, please contact our office in Walnut Creek, California today at (925) 943-6353.

(925) 943-6353
Book an Appointment