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A large
areola can be inherited or may be a result of stretching
of the tissue from weight gain, breast implants, or
pregnancy and breast feeding. Usually, the areola is
reduced in conjunction with a breast
lift or breast reduction,
however if the breast tissue and nipple are in good
position, and the areola itself is large, a simple areola
reduction can be performed.
For the average sized breast (B
to C cup), a desirable areola diameter is 4 to 5 centimeters.
To be proportional, smaller breasts look better with
smaller areolas, and vice versa. Areola reduction can
be performed with local anesthesia since the surgery
involves a small area and is only skin deep.
The planned, smaller areola is marked
by drawing a circle around the areola. A template of
the desired diameter (around 4.5cm, depending on the
breast size) with a hole in the center is placed over
the nipple, and an outline is made with a surgical marker.
Then, a slightly larger circle is made outside of the
first circle to mark the outer edge of the areola.
The surgeon will cut along the skin
where the areola was marked at the inner and outer lines
and remove the epidermis (top layer of skin) of areola
tissue between the two concentric circles. Then the
two remaining edges (where the lines were drawn) will
be sewn back together, resulting in the smaller areola.
Because tiny muscles in the areola
can contract involuntarily, the final result may end
up being larger than intended when the muscles relax.
For this reason, some doctors draw the areola at less
than 4 centimeters, knowing that the final diameter
will be slight larger. Alternatively, a surgical assistant
may keep the areola stretched out while the markings
are made to prevent muscle contraction.
Risks of areola reduction
surgery are minimal, but may include irregular shape,
areola too large or too small, infection, scarring,
and changes in nipple or areola sensation.
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