Breasts come in different forms, and the nipple and areola are among the most important anatomical structures for aesthetically pleasant breasts. One of the things that I see routinely is an enlarged areola. What is an enlarged areola? Well, an enlarged areola in my opinion is an areola that is bigger than 4 to 4 1/2 cm. The areola is made of skin with some glands, and many times, it enlarges with pregnancy, creating disharmony between the areola and the breast mound.
One thing that needs to be considered is that whenever you are placing an implant, attention needs to be paid to the areola, because whenever an implant is placed through any of the possible incisions, the areola is going to get slightly larger because the skin stretches to accommodate the new volume of the augmented breasts. If your areola is enlarged before surgery, you are going to have an even larger areola after surgery. One thing that can be done during a breast implant procedure is reducing the areola. I typically like to make an areola of about 4 cm. Once the excess skin is removed, I suture the areola with a very strong suture to keep the areola from getting wide, and then the rest is closed using interrupted sutures that are absorbable.
Paying attention to the nipple-areolar complex as it relates to the breast size and shape is very important to create harmony between these two important anatomical structures of the breasts.