Some patients require areola reduction and breast augmentation to achieve the most aesthetically pleasing results possible. It should be noted that large areolas make the breasts appear matronly even though these are not droopy.
Leading Orange County plastic surgeon Dr. Tarick Smiley has recently demonstrated on Snapchat the areola reduction and breast augmentation surgery performed in a patient who had “double bubble deformity” in which her breast tissue looked like it was hanging from the implant.
To correct the double bubble deformity and allowed the new implants to settle into their most natural position, Dr. Smiley also performed a simultaneous breast lift.
The patient’s breast lift involved donut-shaped incisions to reduce the size of her areola. Supplementary incisions from the bottom of the areola and the inframammary fold that were extended across the base of the breast were also used to improve the overall shape and projection of the “breast mound.”
Dr. Smiley reduced the size of the areola by creating a circular incision around the desired diameter, which is about 38-42 mm, and another one at the dark-light skin junction. This donut-shaped incision pattern allowed him to shave off the skin (epidermis) in between, a technique medically referred to as de-epithelization.
Dr. Smiley said all efforts are made to reduce tension during the closure of areolar incisions to prevent healing problems and re-expansion or “spreading” of the areola, which may happen over time. Hence, he used several deep rows of sutures in which the tissue, not the skin, would receive most of the “tautness.”
Reducing tension on the skin would also allow the scar to fade nicely into the background, said the celebrity plastic surgeon.
Because the circumference of the outer incision was larger than the inner incision, the skin of the areola’s margin was “gathered” during the closure. This resulted in the pleated appearance of the new areola’s border, although within a few months this will flatten out.
To further achieve a nice breast shape and size, Dr. Smiley created “more distance” between the areola and the inframammary fold. In most cases, the ideal areola position is about 3 cm above the breast crease, he explained.