Areola Reduction Surgery
During treatment for breast cancer with a mastectomy, the nipple and areola are typically removed along with the rest of the breast. Some individuals may be able to undergo a nipple-sparing mastectomy, though in most cases, a mastectomy involves the surgical removal of the breast and the nipple. Our plastic surgeons in Gainesville with John W. Tyrone M.D. Aesthetics & Plastic Surgery are proud to offer specialized reconstructive surgery, including areola reduction, for patients seeking to restore their appearance following medical treatments, accidents, injuries, and congenital issues.
The decision to undergo areola reduction surgery is entirely up to the individual, assuming they are healthy enough for reconstruction and that their tissue is properly healed following their mastectomy. Whatever you decide, we look forward to providing you with all the information you require regarding breast surgery and helping you move forward through each step of your journey through recovery and restoration. Contact our plastic surgery practice today to learn more about our plastic surgery procedures and to schedule areola reduction.
Areola reduction surgery proves effective for many patients seeking to restore their nipples and areolas, though it is worth noting that patients treated with radiation are more likely to experience post-surgical complications than those who have received alternative forms of therapies for their cancer treatment. There are several approaches which may be used in the reconstruction of the nipples, depending on the condition of a patient’s new breast tissue, our surgeons’ preferences, and a number of additional factors unique to the patient. Contact us to learn more about our available reconstructive procedures.
During a skin flap areola reduction procedure, small flaps of skin from the reconstructed breast are folded and sutured together in order to build a mound that will become the nipple. The existing skin on the breast is surgically altered to provide the nipple with an elevated appearance in comparison with the surrounding breast mound. To make the nipple appear more defined and erect, additional skin, fat, or synthetic fillers may be used.
When patients undergo nipple construction or areola reduction, they may not have enough tissue to successfully create a nipple from the new breast. In these cases, our surgeon may use a skin graft. Skin grafts are typically taken from the abdomen, thigh, crease of the buttocks, or the groin area where the legs meet the torso. In some patients, skin grafts may have an increased rate of complications after surgery. Your surgeon will help you determine your best option.
Nipple reconstruction and areola reduction a may be performed on one or both breasts. For patients who have undergone mastectomy, if the nipple on the unaffected breast is large enough, a portion of it may be grafted onto the newly created breast. This procedure is known as autologous graft or nipple sharing and it offers the benefit of restoring a mutually similar appearance of both nipples.
Medical tattooing, also known as nipple tattooing or nipple tattoos, is widely used to recreate a natural-looking nipple and areola. Nipple tattoos may be used in combination with skin grafts to help ensure a natural appearance. Patients seeking to avoid additional surgeries may choose this procedure, though it doesn’t offer the benefit of a technically elevated nipple. Pigments are chosen to match the other nipple. This procedure is usually done after nipple and areola reduction. Over time, pigments can fade, requiring touch-ups to retain the desired result.
Can Nipples Be Rebuilt?
In most cases, yes! Reconstruction procedures of the nipple and areola typically take place during the final phase of breast surgery and are performed by skilled plastic and aesthetic surgeons. This is a separate procedure performed to make the reconstructed breast appear as closely as possible in size, shape, position, coloring, texture, and projection of the natural breast or to each other if both nipples are being reconstructed. The tissue used to reconstruct the nipples and areolas comes from the newly created breast or from skin located on another area of the patient’s body. If a patient desires to match the color of the nipple and areola to that of the other breast, medical tattooing may be performed multiple months following the procedure.
Skilled plastic surgeons and medical tattooing professions may be able to use pigment in multiple shades that achieve the appearance of a 3-dimensional nipple with tattoos. Another option for patients seeking to restore the appearance of removed nipples is nipple prosthetics, which may be made from a number of different materials, such as silicone, that look and feel as real nipples do. While prosthetics do offer the benefits of appearing natural as almost indistinguishable from the natural nipple, they are not attached to the body permanently and can be taken off whenever the patient chooses.
How To Prepare For Areola Reduction
In most cases, areola reduction surgery usually takes place 3–4 months after breast surgery, providing the new breast, or breasts, with adequate time to fully heal. Before their procedure, patients attend an initial consultation, during which they discuss a number of different details with their plastic surgeon, such as their expectations for plastic surgery, any previous surgeries, their medical history, and which alternative or additional procedures may best benefit their aesthetic and cosmetic goals. Patients should check with their surgeon to see what type of anesthesia will be used in their procedure and should arrange to have someone drive them home afterward.
During the consultation with your plastic surgeon, a physical exam of the breasts and the surrounding skin, and an assessment of their placement, size, shape, and symmetry will also be conducted. If the patient is confirmed as a candidate for this procedure, they will then be instructed about which areola reduction surgery preparation protocols to follow. In preparation for their procedure, patients should follow their surgeon’s instructions regarding diet, fitness, rest, medications, supplements, and hygiene. For additional information regarding pre-operative instructions for areola reduction surgery, please contact our office.
Areola Reduction Surgery
In cases where breast implants either made from silicone or saline are used to reconstruct the breast or breasts, nipple surgery is typically performed after the breasts have healed from reconstructive surgery. This healing process usually requires 3 or 4 months, though healing times can vary from patient to patient. In some cases where the breast is rebuilt using skin from the abdomen, the nipple may then be reconstructed at the same time or at a later date, depending on the requirements of the patient and the recommendations of the surgeon. Depending on a number of different considerations, such as the patient’s treatment plan, health requirements, and cosmetic preferences, as well as whether other procedures, such as breast implant revision or breast lift, are to be performed in combination with this surgery, the time required to complete a nipple reconstruction and areola reduction can vary. In general and depending on the technique used, most procedures can take anywhere from 30 minutes to more than an hour. Contact John W. Tyrone M.D. Aesthetics & Plastic Surgery for additional information about this procedure and the different techniques used.
How Long Does It Take To Heal From Areola Reduction?
In most cases, areola reduction is performed on an outpatient basis, meaning patients will return home the same day that they receive surgery. Patients will likely wear a dressing for the days following their procedure to help contain and minimize swelling in the treated areas. While healing, the nipples will feel tender and can be easily injured. In some cases immediately following surgery, the reconstructed nipple may appear more pointed outwards than anticipated, though it will flatten to a normal appearance once it heals. Nipples reconstructed using the skin graft technique may have a plastic nipple protector sewn onto the surrounding skin to shield the nipple from harm during healing. Usually, any dressings applied to the breast or breasts must remain on until they are removed during the post-surgical exam. If patients have their nipple and areola tattooed, then they may experience some flaking and crusting in the area for a few days. Your plastic surgeon will advise you how to best care for your new nipples and prescribe any topical or oral medications to aid in effective healing and optimal results. Patients should avoid using any harsh soaps or products as well as avoid scrubbing the nipples until they heal.
Areola Reduction Surgery Cost
The cost of an areola reduction procedure varies, depending on the exact treatment plan chosen, any additional procedures to be performed in combination with the procedure, and the extent of the procedure, among other variables. Please refer to our plastic surgery costs page for areola reduction surgery cost estimates. For additional information about pricing for plastic and reconstructive surgery, please contact John W. Tyrone M.D. Aesthetics & Plastic Surgery to schedule a consultation with our plastic surgeons.
How Painful Is Areola Reduction?
For most patients who have undergone a mastectomy, the amount of sensation felt in the breasts is significantly reduced following their procedure. As such, patients likely won’t feel much pain or tenderness in the nipple area after their areola reduction. If skin was grafted from another part of the body during the procedure, the donor site is likely to feel tender or painful for a week or more. Your plastic surgeon will discuss with you any medications you can take to ease any pain you may have during the recovery process.
Areola Reduction Risks
As with all surgical procedures, areola reduction carries some risks. The most common risks include tissue breakdown, nipple flattening, and poor positioning, as well as risks of undergoing anesthesia and general health risks associated with surgical procedures. Your plastic surgeon will explain in detail the risks associated with your surgery. Other possible risks of breast and areola reduction surgery may include but are not limited to anesthesia risks, asymmetry, bleeding, deep vein thrombosis, fat necrosis, seroma, hematoma, infection, changes in skin sensation, pain, poor healing at incision sites, looseness of skin, skin loss, skin discoloration, and unfavorable scaring. For more information about potential risks of areola reduction, please contact our plastic surgery office.
Will I Still Be Able To Breastfeed?
Many patients who undergo a mastectomy choose to have children and wonder if they will be able to breastfeed following breast and areola reduction. In most cases, nipple repair surgery should not interfere with a patient’s ability to breastfeed. If the nipple procedure is performed in conjunction with breast reduction, however, the patient’s ability to breastfeed likely depends on the amount of tissue removed during the breast reduction procedure, among other factors. Patients may want to wait until they are finished breastfeeding their children to undergo and complete these procedures. If waiting is not an option, it’s important to note that the more time that elapses between the surgery and the start of breastfeeding, the better.