Areola Reduction Surgery: What to Expect

Areola reduction is an option for any man or woman who’s not happy with the size of their areolas.

This procedure works well if you’ve lost a significant amount of weight and, as a result, have stretched areolas. It also works well if your areolas changed after pregnancy or breastfeeding.

Other ideal candidates include people with puffy or protruding areolas. Some people with asymmetrical areolas choose to get one reduced to match the other.

For women, areola reduction surgery shouldn’t be performed until breasts are completely done growing, usually by late teens or early 20s. Adolescent males may be able to have this procedure done at an earlier age.

The cost of areola reduction surgery depends on a variety of factors, including your geographic location. The biggest determinant of cost is the type of procedure you get.

If you plan on combining it with a breast lift or reduction, the cost will be higher. Done by itself, areola reduction surgery can cost anywhere from $2,000 to $5,000.

Areola reduction surgery is a cosmetic procedure that’s not covered by insurance. You’ll have to pay for it out-of-pocket. Some clinics offer payment plans that can help you afford treatment.

Choosing the right surgeon to perform your areola reduction surgery is important. Look for someone who is certified by the American Board of Plastic Surgery.

Certified plastic surgeons are held to a higher standard than cosmetic surgeons. Board-certified plastic surgeons have at least six years of surgical training, with at least three years specializing in plastic surgery.

Make sure you ask to see the portfolio of any surgeon you’re considering. This can help you see the work the surgeon is capable of, as well as identify the results you’re going for.

Once you’ve selected a surgeon, you’ll have a consultation appointment to discuss what comes next. During the appointment, you should expect your doctor to:

• examine your breasts
• listen to your aesthetic concerns
• go over your surgical options
• ask for your complete medical history, including a list of current medications

If your doctor determines that you’re healthy enough for surgery, they’ll explain the procedure to you. They can also show you where to expect scarring. They’ll give you an idea of what your breasts will look like after your surgery and make sure that your expectations are realistic.

Following your consultation, you’ll be given a date for your surgery. The doctor’s office will provide you with specific preparation instructions.

This may include:

• avoiding certain medications, like aspirin and ibuprofen, for a week prior to your surgery date
• scheduling time off for your procedure and to allow for recovery
• arranging a ride to and from your procedure
• fasting the day prior to surgery if general anesthesia will be used
• showering with a surgical soap on the day of surgery
• avoiding makeup and other cosmetics on the day of surgery
• removing all body jewelry on the day of surgery
• wearing comfortable, loose-fitting clothing on the day of surgery

Areola reduction surgery is a fairly simple procedure that can be completed in about one hour. Your surgery may take place at your doctor’s surgical clinic or at a local hospital.

When you arrive, your nurse will:

• Ask you to change into a hospital gown. You’ll be asked to remove your bra, but you can keep your underwear on.
• Check your blood pressure.
• Insert an intravenous line. You may be given a medication to help you relax and another to put you to sleep.
• Apply electrodes used to monitor your heart rate during surgery.
• Confirm that you have fasted if necessary.

Before surgery, you’ll meet with your doctor to go over any last-minute questions or concerns. Your anesthesiologist will administer a local anesthetic or prepare you for general anesthesia.

During the procedure:

1. Your doctor will cut a doughnut-shaped piece of tissue out of your areola.
2. This circular incision will be made along the border of your existing areola, where the scar can be more easily hidden.
3. They’ll secure your new areola with a permanent suture deep inside your breast. This suture will prevent the areola from stretching.
4. They’ll use removable or dissolvable stiches to close your incision site.

Your doctor may fit you with a special postsurgical bra or apply surgical dressings.

If you received a local anesthetic, you’ll be able to go home almost immediately after surgery. If you received general anesthesia, your doctor will monitor you for a few hours before discharging you.

Areola reduction surgery is very safe, but like all surgeries, it comes with risks.

This includes:

• Loss of sensation. During areola reduction surgery, doctors leave the center of your nipple in place to reduce the risk of sensation loss. You may have a temporary loss of sensation during the healing process, but this is rarely permanent.
• Scarring. There will be a scar running around the outer edge of your areola, and the severity of this scarring varies. Sometimes the scar fades so much it’s nearly invisible, other times it can be very noticeable. Scars are often darker or lighter than the surrounding skin. Some scars can be improved with areola tattooing.
• Inability to breastfeed. When your doctor removes a piece of your areola, there’s a risk of damage to the milk ducts. Although this is rare, there’s a chance that you’ll be unable to breastfeed in the future.
• Infection. You can drastically reduce your risk of infection by following your aftercare instructions carefully.

Recovery from areola reduction surgery is relatively quick. Although you may have some swelling and bruising, you can usually go back to work in one or two days.

Your doctor might mention that you should:

• expect an increase in pain during your first postsurgical period
• take over-the-counter pain relievers like ibuprofen (Advil)
• wear a surgical bra or soft sports bra for several weeks
• abstain from sex for the first week
• abstain from physical chest contact for three to four weeks
• refrain from lifting heavy objects or doing any strenuous cardio for the first few weeks

It may take a few weeks before you’re able to appreciate the results of your areola reduction surgery. An initial period of swelling and bruising often obscures the results.

As the swelling subsides, your breasts will settle into their final position. You’ll notice that your areolas appear smaller and more centered. You’ll also notice a ring-shaped scar around your new areola. This can take up to one year to heal.

You’ll have another consultation with your doctor one to two weeks after your surgery. Your doctor will check your healing and remove stitches, if necessary. Your doctor may also give you topical medications that can help reduce the appearances of scars.

Call your doctor immediately if you experience any of the following:

• fever
• severe redness or inflammation
• sudden increase in pain
• pus leaking from your incision site
• unusually slow healing