Plastic Surgery

Areola Reduction Aesthetics

What is Areola?

The “areola” is the pigmented area around the nipple that can range from pale pink to dark brown in color, can be round or oval in shape, and can vary in size.  Together with the nipple, this area is known as the “Nipple-areola complex.” For a variety of reasons, the areola may be asymmetrical and larger than normal. In such cases, areola reduction surgery can be performed alone or in conjunction with other mammoplasty procedures.

Cases Where the Areola (Pigmented Area around the Nipple) Is Larger Than Normal

It is stated that the color of the areola, which is darker compared to that of the surrounding breast skin, enables the baby to find the nipple more easily.

The Montgomery glands under the skin of the areola looks in the form of slight bumps, and with their secretion, contribute to the moisture and lubricity of the nipple and areola. In addition, during breastfeeding, the muscle fibers in this area contract, making the nipple more noticeable and facilitating the breastfeeding process.

The areola’s diameter can change in response to stimuli such as heat, cold, touching, and breastfeeding; and during menstrual periods, slight changes in size can be observed.


The shape, size and color of the areola are determined by inherited genes. However, these features of the areola may change over time as a result of pregnancy, breastfeeding, excessive weight gain and loss, trauma, aging, breast sagging, and breast augmentation surgery. Areolas are usually neither perfectly round nor perfectly symmetrical. The color of the areola may vary from person to person, and gets darken particularly during pregnancy.

In the deformity known as tubular breast, the breast tissue pushes the areola forward excessively and widens it.  Due to the increased volume under the nipple, the size of the areola increases in men, particularly in those with gynecomastia.

After the treatment of gynecomastia, the areola sizes return to normal, and do not require areola reduction procedure (except in cases of excessively large gynecomastia). Areola reduction can be considered if at least 1 year has passed after gynecomastia surgery but the diameter of the areola is still large.

What is the Ideal Areola Size?

In women, the areola diameter that is considered normal or ideal ranges from 35 to 48 mm. In an aesthetically pleasing breast, the 1:3:9 rule can be mentioned; where the base diameter of the nipple is 1 unit, while the diameter of the areola is 3 units, and the base diameter of the breast is 9 units.

In a scientific study conducted in 2020, where the breast photos of 58 models that have not undergone mammoplasty were analyzed, the ratio of the mean nipple base diameter to the areola diameter was found to be 0.29. (Reference 1) The size of the areola is smaller in males (mean diameter is 28 mm). (References 2)

What is Areola Reduction Surgery?

Areolas wider than normal and deformed areolas can be corrected with “areola reduction surgery”. This surgical procedure can be performed alone under local anesthesia by an aesthetic plastic and reconstructive surgeon, or it can be performed in conjunction with the breast reduction or breast lift procedures.

How is The Areola Reduction Procedure Performed?

Before the surgery, the desired areola size is indicated by drawing circular marks around the nipple. Then, the excess areola tissue outside of this marked circular area is removed as a donut-shaped part under local or general anesthesia. The surrounding breast skin and the areola skin that remained in the middle are brought together with the help of sutures. Thus, the areola becomes more proportional to the size of the breast. If there is a level difference between the two areolas, it is eliminated in the same session, as well.

Who Should Have This Surgery?

Areola Reduction Surgery is not an essential surgical procedure. If the ratio of the areola diameter to the entire volume of the breast is greater than normal, and the person is psychologically affected by this condition, she or he can have this surgery. This surgical procedure can be performed for areola reduction alone, but it is commonly performed in conjunction with mammoplasty procedures such as breast reduction and breast lift. These operations involve both reducing the areola diameter and proving symmetry between the areolas.

Before Surgery

Taking blood thinners such as aspirin, green tea, ginkgo biloba and nutritional supplements should be discontinued 15 days before the operation. There should be no active infection or another pathologic condition in the breast or nipple. During the COVID-19 pandemic, the social isolation precautions and other forms of anti-infective measures should be taken more carefully 2 weeks before the surgery date.

After Surgery

The surgical site is covered with a dressing. The sutures are removed 5 days after surgery, on average. The surgical scar takes its final form within 6 to 24 months. During this period, some creams that contribute to scar healing are applied.

Potential Risks and Complications of the Procedure

  • Infection
  • Wound dehiscence at the suture line
  • Poor Wound Healing (hypertrophic Scar, Keloid)
  • Some undesirable conditions such as the enlargement of the scar may be encountered.

Is There A Non-Surgical Treatment Method That Can Be Used At Home?

There is no non-surgical areola reduction method other than surgical intervention.

Costs of Areola Reduction Surgery in 2024

The costs of areola reduction surgery may vary depending on the hospital where the operation will be performed, the date of the surgery, the surgeon who will perform the operation, and whether or not additional aesthetic procedures will be performed. You can contact our office to know the current surgery price for you.


  1. https://www.sciencedirect.com/science/article/pii/S2352587819300440
  2. https://europepmc.org/article/med/8722981

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