The average areola is approximately 4.5 centimeters in diameter, but they can become enlarged due to natural sagging with age or breastfeeding. Disproportionately large areolae can also be related to heredity and hormonal changes during puberty. Knowledge that the area surrounding the nipple is larger than normal can erode a woman’s self-esteem and lead to intimacy issues, diminished confidence and shame.
Different cultures have differing views on the ideal areola size. Plastic surgeons from Germany prefer smaller areolas, while surgeons in Brazil, the U.S., India and France prefer larger areolas. Despite the prevailing trends, ideal areola size truly depends upon the preferences of the patient.
Areola reduction is a popular plastic surgery procedure around the world, aimed at changing the size, shape, width, texture or asymmetry of the area surrounding the nipple.
Women report life-long insecurity
The UK Daily Mail reports that many women hid their nipple insecurity for years before learning of areola reduction surgery. “My first boyfriend jokingly compared them to Hob Nob biscuits,” recalled one woman. “He meant it fondly but that description stayed with me – and I’ve never been able to move on from it. I’ve felt self-conscious with every man I’ve ever undressed in front of. They have also been compared to Scotch pancakes. They are so disproportionately large – it makes me so paranoid.”
Leteysha Grace, of MTV’s “The Valleys” says that derogatory comments about her breasts have made her consider nipple reduction as well. “I don’t feel at all sexy with my top off. I can’t imagine how any man could find them attractive,” she said, admitting that she leaves her bra on during intimate encounters. “I’d never heard about nipple reduction surgery before — I thought I was stuck with them. Now that I know it exists I’m going to save up to have it done.”
How are nipple reductions done?
The outpatient procedure is typically done under local anesthesia by removing the outermost area of the areola and suturing in the skin with absorbable stitches. A permanent stitch placed deeper in the breast tissue prevents the areola from widening later. The areola can be done as a stand-alone procedure or addressed at the same time as a breast reduction, augmentation or lift to minimize recovery time. Most patients are able to effectively manage their discomfort with pain relievers and are back to work within a few days. The surgeon’s fee will vary depending on location and experience, but financing options are available through most plastic surgery offices.
Areola reduction risks
Areola reduction does not typically cause any problems with future breastfeeding, but risks of the procedure include a loss of sensation (if nerve damage occurs) and scarring (if too much skin is removed). According to Cosmopolitan Magazine, “The area around the nipple is very forgiving when scarring,” but there will still be some type of scar around the nipple that may or may not be hidden by the uneven borders of pigmentation. Risks with any surgical procedure include more serious complications like infection and blood clots, so it’s important to find a highly qualified, board-certified plastic surgeon with experience in the particular procedure you desire.
If you’re interested in areola reduction, call female plastic surgeon Dr. B. Aviva Preminger at 212-706-1900 to schedule a private consultation in her Manhattan office.