Areolas and nipples, just like breasts, come in different shapes and sizes, so there is really no right or wrong size for the areola. But women often have strong feelings about the way their breasts look, and areola reduction is a fairly common procedure.

Areola reduction surgery reduces the size of the dark pigmented skin around the nipple. It can also remove puffiness of the areola and make the nipple stand out less.

Reasons for choosing to have areola reduction surgery

Women seek areola reduction for a number of reasons, but mainly to meet a desired standard of beauty or return to the time before weight gain, pregnancy or ageing took its toll. Although the size of the areola is often genetic, it can increase with age as the skin loses elasticity and sags. Breast implants and weight change can also impact the size of the areola. Areola reduction is often combined with other procedures such as breast reduction, breast lift or breast augmentation surgery.

There are no medical reasons to opt for an areola reduction, but if you feel your areolas look large and out of proportion to your breasts, especially after a breast lift or breast reduction surgery, if your areolas have become enlarged or stretched after childbirth or after significant weight gain; or if, for any other reason, you don’t like the way your areolas look, areola reduction surgery may be for you.

What to expect

Areola reduction is usually performed on an outpatient basis. The procedure takes between 1 and 2 hours, and you can go home after the effects of the anaesthetic wear off.

After an incision is made around the nipple, some of the dark pigmented area of the areola is removed, and the incision is closed. You can take a shower and get back to normal activities within a few days following the surgery. Expect a follow-up visit to your surgeon after one week. You should see a difference in the shape and size of your areolas immediately following surgery.

The incision on the breast is small and the sutures dissolve, so there is no suture-removal process. The scars from this procedure are not usually prominent and will fade with time.

Before and after surgery

There is no special preparation required for this procedure. There are, however, several things you can do leading up to any kind of surgery.

There are also a number of  things you can do following any surgery.

There are special instructions to follow after areola reduction surgery to maintain the desired shape of the nipples and areola and ensure healing:

• Ice the area to reduce swelling.
• Avoid lifting anything weighing over 1 kg in the first few days.
• Avoid bending over or reaching above your head for a few days.
• Wear a support bra for the first 3 weeks following surgery.

Possible risks and complications

As with any surgical procedure there are risks involved in areola reduction surgery. You should be fully aware of these before you elect to have the procedure. Make sure you familiarise yourself with the list of complications that can arise as a result of any surgery.

The best way to reduce risk is to find a fully qualified surgeon with formal training in areola reduction who has performed the procedure many times.

Specific complications that may occur after areola reduction surgery:

• Loss of sensitivity and numbness may occur during the healing period. Mostly this is temporary, but numbness may be permanent.
• Nipples may become uncomfortably sensitive.
• Your ability to breast-feed may be compromised.
• The two areolas may not be equal in size or are at different heights. These issues will require corrective surgery.
• Visible scarring and loss of pigmentation is possible and can be rectified with scar-fading treatments.

Just as you would discuss potential benefits before surgery, it is always advisable to ask your surgeon to address the potential risks that apply to you.

Rough costs involved

The cost of an areola reduction procedure can vary depending on the surgeon and the facilities used. Your surgeon will help you estimate potential costs.

You can expect to pay around $5,000 (AUD) for areola reduction surgery. This includes the surgeon’s and assistant surgeon’s fees, fees for the anaesthetist and the hospital cost.

Some Australian private health insurers may help pay for the hospital bed and theatre fees. Getting a doctor’s referral will enable you to make a claim on these costs.

You should expect the costs to be higher if you are having combined procedures at the same time

This information is correct as of 2019.