Large areolas?

[marffeus]

Hey guys,

Been lurking here for a while (ever since I found out what I have is an actual condition and not just cruel fate) and  had a question for anyone out there who knows. Basically I have had gynecomastia for as long as I can remember (I'm 23 now) and since I have a full-time job, I can actually afford to pay for surgery, should I opt for it.

One theme echoed here about surgery, and happiness with results, is to have the right expectations. Well, probably the biggest reason I hate the look of my chest is due to my very large areolas (the soft pink skin that surrounds the nipple, FYI). I believe the reason it looks so large is due to an enlarged gland expanding the tissue. In fact, the way I discovered gynecomastia originally was by googling "Areaola reduction" surgery, and none the less came across gynecomastia.

My question is, should I expect to see at least some decrease in the size of my areola, as well as more definition of the nipple (majority of the time my nipple is not "erect" and just lies with the areola unless I'm cold  ) Of course the breast reduction would be an added bonus (I hate watching people's eyes at work glance down at them, as if I didn't notice  )

I need to lose weight anyways, since I want to be about 160 (currently ~195) and 5'9", so I have more time to think and save money. I was at 160 (Lost from 240 down to 160) for a while about 2 years ago, and while my breasts did shrink considerably, my areolas were still very large (no change) and still definitely had breasts. To be honest, the main motivation for the weight loss was for the hopes of my chest improving in its looks, and since it didn't, I think this contributed to some of my weight regain. 

Sorry for the long winded post, but any input is appreciated.

[Grandpa Bambu]

Your areola 'should' decrease in size after GRS...

GB

[mrpower33]

Bermant can do an areola reduction with the gyne surgery.  You should look into him if that's what you're looking for.  He did my surgery (puffy nipples, excision w/lipo). 

[Grandpa Bambu]

Unless your areolas are overly large, they should reduce in size considerably without having the 'doughnut' procedure...

GB...

[shen]

Don't leave it up to "hope" that your areolas will shrink, most likely they will not.

Everyone's nipples are different sizes, and if yours are naturally larger, and have been "puffed out" and stretched from years of gynecomastia, expect them to keep some of that size without the gland. They may not "puff" after proper surgery, but they will still be stretched/large.

I did not have areola reduction and I am now regretting it.

[Grandpa Bambu]

I did not have areola reduction and I am now regretting it.

Do you have any Before/After pics of your areolas dude?

GB...

[i_dont_know]

They may.

I had my surgery just over a week ago and I had pinkish-puffy nipples (the areolas weren't huge, but they protruded) and ever since.. even at this point, my nipples look a bit smaller and they are laying flat now. Also a bit darker in color which I'm guessing is just from the surgery, but they actually look MUCH better than they did before and I didn't have specific work done there, just had the glandular tissue removed through excision and any bit of excess fat through lipo.

Once the nipples lay flat, you probably won't worry about the size as much anymore.. they may naturally decrease in size anyway (mine appear to have).

[dondante]

mine are definitely smaller because of my surgery, and my surgeon didn't go anywhere near my areola. I'm sure they would be smaller if they hadn't been stretched by 22 years of gyne - but they are smaller.

[Grandpa Bambu]

They may naturally decrease in size anyway (mine appear to have).

Mine are definitely smaller because of my surgery.

GB...

[Dr. Elliot Jacobs]

Virtually ALL areolas will spontaneously shrink to some degree after surgery.  In my experience, they will shrink on average about 15 - 20% from the original areolar diameter.  Shrinkage is due, in part, to liposuction performed on the surrounding areas of the chest, which stimulates skin shrinkage and tightening as well as direct excision of tissue under the areola.  I do not recommend a donut (of skin) excision to further reduce the areolar diameter -- the scars are very poor.  Better to have slightly larger areolas than to walk around with poor scars which are permanent and difficult to conceal.

Another change in the areolas is that they become darker in color.  All areolas have some extra pigment -- that is why they are darker than the surrounding skin.  When the areolas shrink, the individual pigment cells are then even more "crowded" together (ie more intense pigment) and so the areola as a whole appears darker.

You can appreciate the change in diameter and change in color by looking at some photos:  www.gynecomastianewyork.com/photo.asp     look at 13a and 13b as an example.

Dr Jacobs

[DrBermant]

Hey guys,

Been lurking here for a while (ever since I found out what I have is an actual condition and not just cruel fate) and  had a question for anyone out there who knows. Basically I have had gynecomastia for as long as I can remember (I'm 23 now) and since I have a full-time job, I can actually afford to pay for surgery, should I opt for it.

One theme echoed here about surgery, and happiness with results, is to have the right expectations. Well, probably the biggest reason I hate the look of my chest is due to my very large areolas (the soft pink skin that surrounds the nipple, FYI). I believe the reason it looks so large is due to an enlarged gland expanding the tissue. In fact, the way I discovered gynecomastia originally was by googling "Areaola reduction" surgery, and none the less came across gynecomastia.

My question is, should I expect to see at least some decrease in the size of my areola, as well as more definition of the nipple (majority of the time my nipple is not "erect" and just lies with the areola unless I'm cold  ) Of course the breast reduction would be an added bonus (I hate watching people's eyes at work glance down at them, as if I didn't notice  )

I need to lose weight anyways, since I want to be about 160 (currently ~195) and 5'9", so I have more time to think and save money. I was at 160 (Lost from 240 down to 160) for a while about 2 years ago, and while my breasts did shrink considerably, my areolas were still very large (no change) and still definitely had breasts. To be honest, the main motivation for the weight loss was for the hopes of my chest improving in its looks, and since it didn't, I think this contributed to some of my weight regain. 

Sorry for the long winded post, but any input is appreciated.

Areola Reduction Surgery is a significant compromise that I rarely recommend unless there is a great deal of excess skin (such as After Massive Weight Loss or in large breast Transgender Female to Male Chest Contouring.) There are many techniques to tighten the skin and remove areola, each has their own compromises.  However, flat nipples hanging well below the pectoral muscles look much worse than scars from reduction.  For major amounts of excess skin, a Skin Reduction Chest Lift may be an option.  Depending on sutures to hold areola tissues at a smaller size is a real risk as seen in the example below where I revised a mess from Australia surgeon's use of dissolvable sutures.  Permanent sutures can break, stretch, and get infected.  Such risks are better explored during a consultation after an evaluation.

Warning Graphing During Gynecomastia Areola Reduction Surgery Pictures

You can see actual pictures during a  Revision Donut Mastopexy Areola Reduction Surgery here. 

Photographs during surgery to reduce big areola continue here. and there are more Pictures during surgery to reduce male areola here.

The areola usually expands with bigger breasts.  Like a balloon, with deflation (surgery) there is a reduction in diameter unless there is a layer of remaining gland after gynecomastia surgery.  Roll your cursor over that text or image and you can see a drawing of gland that can be left behind after surgery.  I have seen many examples of gland adherent to the muscle areola complex that keeps the areola puffy and larger diameter.  That is why I prefer to target the gland first with my Dynamic Technique for Gynecomastia.

Check out the many before after pictures of this  Areola / Nipple Reduction Gallery, Areola Reduction Picture Gallery, and Pictures of Areola Reduced with Gynecomastia Surgery.  These results are typical for my sculpture of my patients.

Here is a balloon demonstration of nipple / areola shrinkage typically seen with my gynecomastia surgery.  When a breast gets bigger, so does the diameter of the areola nipple complex.  Remove tissue from the breast and it is like this balloon deflation.  However, not all tissues shrink the same.  Tissue over stretched, older patients, scars, and gland remaining after gynecomastia surgery can limit this decrease.  Here is a demonstration of deflation with areola staying the same size.  That is why I prefer to target this gland first with my surgery.

Take your time to browse through the galleries of nipple areola pictures before and after gynecomastia surgery to see actual results for my patients.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia of Male Chest Ptosis - Sagging and Male Mastopexy Chest Lift Sculpture

[marffeus]

Wow, great replies all! I really appreciate the time taken by both Dr. Bermant and Dr. Jacobs for the in depth explanations. I will definitely continue to save up for the surgery 

[marffeus]

Figured adding photos wouldn't hurt.

http://www.flickr.com/photos/37675009@N06/3464855102/in/photostream/

http://www.flickr.com/photos/37675009@N06/3464855120/in/photostream/

So... think my areolas would shrink some? They seem pretty puffy and are very soft. I wouldn't care even if they shrunk all that much, maybe just "firming" up would work. My expectations aren't too high heh

[DrBermant]

Figured adding photos wouldn't hurt.

http://www.flickr.com/photos/37675009@N06/3464855102/in/photostream/

http://www.flickr.com/photos/37675009@N06/3464855120/in/photostream/

So... think my areolas would shrink some? They seem pretty puffy and are very soft. I wouldn't care even if they shrunk all that much, maybe just "firming" up would work. My expectations aren't too high heh

Each patient can be different.  As shown in the prior answer, typical patients have smaller diameter areola after surgical removal of mass.

Areola can even shrink with weight loss.  I just saw another patient in the office today who I had documented his areola diameters on his last visit to our office.  After losing weight, the areola diameter were now 1/3 smaller.  (Same temperature room which I also document.) 

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[marffeus]

Thanks again Dr. Bermant. I agree that everyone is surely different in how their bodies will respond to the surgery. I was at a normal weight (about 160lb) 2 years ago, and although I never did measure my areola diameters, I know they didn't shrink a whole lot (but they did shrink some).

Is it pretty apparent there is gynecomastia present? Are nipples like mine (larger and somewhat puffy) generally a result of glandular tissue, or fat tissue, or neither?

Thanks