Areolar reduction is a surgical procedure that reduces the size of the areola.   The areola may be large in proportion to overall breast size due to genetic or acquired factors.  Some women report longstanding concerns regarding areolar size since breast development. Asymmetry may motivate others to consider this procedure, which may be performed on one or both sides as needed. Women may develop areolar enlargement over time as the nipple areolar complex is placed under stretch during pregnancy and breastfeeding. The procedure may also be performed to correct size or shape irregularities following previous breast surgery. Here are 5 FAQ regarding areolar reduction:


  • How is areolar reduction performed?

Areolar reduction reduces the circumference of the areola by removing redundant tissue around the periphery.   Following removal of this donut-shaped areolar tissue, the breast skin is then cinched down and stitched in a circular fashion around the new areolar circumference. The scar is placed along the skin-areolar border, which is a natural junction and helps to conceal the scar once healed.   While there is no ideal areolar diameter, the new areolar size is designed to be in proportion to the overall breast mound. A range of sizes may be selected in order to achieve the best aesthetic outcome for each patient. Dissolvable sutures are placed, which gradually resorb over a few months post-operatively.


  • What type of anesthetic is used?

Areolar reduction may be performed under local or general anesthetic. If performed under local freezing, a series of small injections are first performed to achieve pain control during the procedure. There should be no discomfort experienced during the surgery.  The local anesthetic also reduces bleeding during the areolar reduction. Depending on patient preference, clinical presentation, and whether additional surgery is being performed, general anesthetic may also be used. This is most common when breast augmentation or a lift is being performed during the same procedure.


  • How painful is areolar reduction?

Patients generally require prescription pain medication for a few days post-operatively. The resection is superficial, however discomfort is common during early healing. Patients may transition to Tylenol plain within a few days and then discontinue all analgesics when able. Applying cold compresses over the first 24-48 hours may also help to reduce localized discomfort, swelling, and bruising.


  • What is anticipated recovery following areolar reduction?

Patients may resume office-based work within a few days. Exercise and heavy lifting should be avoided for 3-4 weeks as wounds gain tensile strength and early healing takes place. Steri strips are placed overlying the incisions, which gradually fall off within a couple of weeks.   Patients may resume showering on the day following surgery.


  • How long do results last?

Once scar maturation has completed by one year post-operatively, results should be stable. If pregnancy and breastfeeding takes place following surgery, areolar enlargement may recur as the nipple areolar complex is further stretched. This may also occur following weight fluctuation.


Please contact us if considering cosmetic breast surgery in the Toronto area to schedule a consultation with female plastic surgeon Dr. Stephanie Power.

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