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The areola is the colored portion of skin surrounding the nipple. Many people confuse the two, but they are two distinct body parts. Sometimes after weight loss, breast augmentation or breast reconstruction surgery, the areolas can stretch and appear out of proportion with your body. Some women who suffer from areolae that are too large for their breasts inherit the condition genetically. The condition can be corrected with a variety of cosmetic procedures. However, care must be taken when working with the areola that the nerves and vessels that supply the nipple are not damaged. Damage to those sensitive areas can cause numbness in the nipple and hinder response to external or erotic stimuli. There are several alternative procedures used to ensure that the nipple is not affected, and the areola reduced symmetrically to ensure a pleasing aesthetic appearance. Procedures In areola reduction surgery, two circular incisions are made, one inside the other around the edges of the areola. The resulting doughnut shaped tissue and excess skin is surgically removed. The area around the nipple is left intact with the nipple is still attached to its blood and milk supply. A long suture is made around the outside of the incision and drawn together like a drawstring, this helps relieve stress on the inner sutures. The incision is then sutured closed, usually with dissolving sutures. The surgeon attempts to hide the scar in the edge of the areola, which will fade over time. Another procedure is known as the lollypop procedure. In this procedure, the bottom for the doughnut shape is removed, and the areola closed around the nipple. A tiny scar underneath the nipple is what gives this option its distinctive name. The surgery is usually takes approximately two hours to complete and can be performed under light sedation, or general anesthesia. It can be performed as the same time as other procedures like breast augmentation or breast lift. The resulting scars are usually faint. Because the nipple is not affected, you can usually resume breast-feeding. The nipple will still be responsive to external and sexual stimuli as well. Some scars discolor the areolae, which is called hypopigmentation in some patients. This is a loss of skin pigmentation that results in lighter areas of skin. Pigmentation can be matched with areola tattooing, or micropigmentation. Scar tissue is more difficult to tattoo than normal skin so you'll want to be sure to select a cosmetic surgeon who is skilled with this procedure. Temporary and permanent puckering is possible after areola reduction surgery. Usually this is caused from the drawstring suture that is used to gather the tissue together. The puckering effect might go away after approximately six weeks. If the problem persists beyond that time, a follow up procedure to correct the scarring may be performed. Most women take just a couple of days off work for areola reduction surgery. After surgery, you can resume your daily activities almost immediately. Typically, there is little pain, swelling, or bruising post operation. The incisions will be fully healed in a few weeks. There may be scarring, but they will be minimized as much as possible. Like all surgeries, there are certain risks involved, including problems with the anesthesia, pain, persistent numbness, infection and necrosis, or tissue death. To minimize these risks it is important to find a highly qualified cosmetic surgeon who has plenty of experience in areola reduction surgery. If you are in the San Francisco, California area, and would like to learn more about areola reduction, please contact the office of Dr. Randall Weil.
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