Areola Reduction Surgery - A Complete Guide

Introduction

Areolas are hyperpigmented ring-like circular areas of skin surrounding the nipples of breasts. The areolas of each person differ in color, shape, and size (circumference). Areola reduction surgery is a simple cosmetic surgical procedure to reduce the areolas' rim.

Who Requires Areola Reduction Surgery?

Generally, areolas with broad circumferential areas are not considered pathological. However, males and females can opt for surgery if there is a sense of discomfort with large areolas. It can also be done along with breast lifting or breast augmentation procedures. Areola reduction surgery is commonly done in the following situations.

• In males, the size and shape of areolas are within the normal esthetic range. However, in cases of gynecomastia, the affected male shows a large breast-like structure in the chest that may show abnormally large areolas. In such cases, a reduction of areolas may be required.

• In females, the areola size and shape may appear abnormal due to drastic reduction in weight, asymmetric breast size, and shape and development of areolas after pregnancy.

Types of areola that require reduction surgery include:

• Puffy areola.

• Asymmetric areola (relatively large).

• Large areolas in gynecomastia.

• Areolas of the breast after drastic weight reduction.

• Large areolas after parturition.

Who Does the Surgical Procedure?

The procedure is done by a certified plastic surgeon who has excelled in gynecology surgeries. It is always advisable to prefer a plastic surgeon over a cosmetic specialist since the procedure can be done esthetically and without postoperative complications.

What Are the Procedures Done Before the Surgery?

During a consultation with the surgeon, the following procedures are followed.

1. Record of chief complaints and the issues with large areolas.

2. Discussion of the patient's medical history in detail.

3. Clinical examination of breasts.

4. Explanation of areola reduction surgery.

5. Consent for treatment.

Based on the chief complaint and medical history discussion, the surgeon will decide the patient's eligibility for surgery. Areola reduction surgery is a minor procedure generally done on an outpatient basis.

The surgeon will explain the procedure's possible outcomes, risks, and complications. In addition, patients will be asked to follow certain medications and diet plans on the day of surgery.

What Is the Procedure?

Areola reduction surgery is a minor surgical procedure done within two hours.

Pre-operative procedures include:

1. General physical examination.

2. Examination of pulse, heart, respiratory rate, and blood pressure.

3. Overview of complete hematological investigations to check if the values are standard on the day of the procedure.

4. Administration of pre-operative medication to reduce the stress and anxiety of the patient.

5. Since the procedure can be done under local or general anesthesia, the surgeon will decide on the required preparations and advise accordingly.

Operative procedures involve the following steps:

• Once sufficiently anesthetized, the vitals are rechecked, and the surgeon will start the procedure once it is under normal limits.

• A well-defined circular incision is made in the areola, and some acceptable amounts of tissues are removed with the help of pre-surgical templates prepared by the surgeon. This is customized to the size or shape of the patient's requirements.

• The remaining altered areolar tissues will remain in the breasts and are positioned with the help of resorbable sutures.

• After the procedure, a surgical dressing is applied over the sutural areas.

• The recovery is rapid if the procedure is done under local anesthesia.

• The procedure is carried out under general anesthesia. It takes 2 hours for the recovery. The patient's vitals will be monitored until recovery from anesthesia is completed.

What Are the Measures to Be Followed in the Postoperative Period?

• Pain and swelling surrounding the areola that underwent surgical procedure will be there for some days. So, pain-relieving and anti-inflammatory tablets should be taken for at least three to four days.

• Wear only a surgical bra that may not interfere with the healing of the surgical wound.

• Abstain from sex or any action that compresses the breast or weight lifting as it may create tension in the sutured region.

• Call the surgeon immediately if findings like severe swelling, redness, excessive pain, or pus from the areola are noticed.

What Are the Benefits of Areola Reduction Surgery?

Here are some potential benefits of areola reduction surgery:

• Improved Esthetic Appearance: An improved esthetic appearance is the main benefit of areola reduction surgery. If the areola is too large or asymmetric, it can be a source of self-consciousness and embarrassment for many individuals. Areola reduction surgery can help to create a more balanced and proportionate appearance.

• Improved Self-Confidence: For many people, having a more proportionate and esthetically pleasing areola can enhance their self-confidence and self-esteem. This can positively impact many areas of their life, including their personal and professional relationships.

• Improved Clothing Fit: Finding proper clothing can be challenging if the areola is large or asymmetric. Areola reduction surgery can help create a more symmetrical and proportionate appearance, making it easier to find clothing that fits well and feels comfortable.

• Improved Comfort: In some cases, individuals with large or asymmetric areolas may experience discomfort or irritation when wearing certain types of clothing. Areola reduction surgery can help to alleviate this discomfort and improve overall comfort.

What Are the Expected Postoperative Complications?

As areola surgery is a simple surgical procedure, no significant complications are expected after the surgical procedure. However, some of the minor complications that are expected to follow the surgery are:

1. Scarring in the Areolar Region: The healing area surrounding the areolar margin shows scar tissue. Sometimes, these scarrings are more marked.

2. Impaired or Loss of Sensation in the Areolar Region: As the nervous tissue in the areola gets damaged during surgical intervention, there is a possibility that the patient may experience altered sensation or complete loss of sensation in that region.

3. Issues in Lactating a Baby: As some or all the milk glands will get removed during areola reduction, lactating mothers may find it difficult or impossible to breastfeed the baby.

4. Patients rarely observe swelling, itching, or redness in the surgical areas.

Conclusion:

Areola reduction surgery has been gaining popularity recently among men and women since people have started to give importance to esthetics. However, always consult an experienced plastic surgeon to do the procedure esthetically and without postoperative complications.