Should I Consider Surgery?

Genetics and Lifestyle

The areola is the colored (pigmented) area around the nipple. This area is rarely totally symmetric and most people are aware that the areola changes with different stimuli changing shape and size. Some men and women become concerned that the areola size is not in proportion to their breast, chest wall, or body shape and desire a change in shape and size. While most people today are aware of Breast Augmentation and Breast Lift procedures to change the size, shape, contour, and position of the breast, but many do not know about Areolar surgery to change the size and shape of the Areola in a safe and predictable manner. The Areolar can change due to genetics, lifestyle, breastfeeding, weight shifts, and normal aging. Nipple and Areolar reduction surgery are very common today as women are more health and body-conscious. Dr. Rudderman uses only the safest and most reliable techniques to achieve truly natural-looking results.

Benefits of Areolar Reduction Surgery

  • The surgery reduces the Areola size to balance it with the breast
  • Areolar surgery improves symmetry of the Nipple/Areolar area
  • The surgery reduces Areola puffiness (Areolar Herniation)
  • The surgery removes prominent bumps (Montgomery tubercles) often caused by Nipple stimulation
  • Areolar reduction surgery can mimic the effect of a slight Breast Lift
  • The surgery results in a more youthful-looking breast

Many women find that Areolar surgery restores the younger-looking breast they had before pregnancy, childbirth and breastfeeding. Dr.Rudderman’s delicate techniques during surgery and special techniques following Areolar surgery, during the healing phase, achieve great healing results rarely requiring scar revisions.

Dr. Rudderman is one of Atlanta’s surgeons of choice. He is specialized in many complicated problems of the breast & he employs delicate, advanced techniques to achieve the most natural-looking results possible.

Good Candidates for Surgery

Do you have any of the following concerns?

  • Overly large Areolae
  • Undesirable shape changes occurred after pregnancy
  • Your Areolae are too large for your breast size
  • Breasts and Areolae have changed in shape & weight
  • Age-related changes are not aesthetically pleasing
  • Areolae are too puffy, prominent, asymmetric or unbalanced

If you answered yes to one or more of these concerns, you could be an ideal candidate for Dr. Rudderman’s Areolar reduction surgery. Good candidates should be in otherwise good health, with no history of breast disease and untreated illness or medical condition that can impair normal healing.


First, a careful evaluation is performed to understand the current condition. This is to understand if the areolas have always seemed too large for your breast, have they been large since puberty, and have changes occurred with age, weight change, and conditions such as pregnancy or hormonal changes including menopause. In men, areolas may become large with puberty, and commonly may look too large after substantial weight loss.

Surgery typically involves an incision around the margin of the areola removing a “doughnut” shaped segment of tissue and closure with sutures. In some cases the operation can be done under local anesthesia, meaning you can drive yourself to the surgery, have a “novocaine” type solution injected, have the operation, and drive home returning to work the next day.

If anesthesia is used, return to work the following day is still likely. Return to exercise is usually 3 weeks, and swimming at the beach soon thereafter. Risks of surgery are very low. There is a low probability of sensation loss or change, and no known impact on the ability to produce breast milk when pregnant. Probability of the need for additional surgery in the future for additional reduction is unlikely.


Dr. Rudderman believes the consultation is critical for you and him. The consultation includes the following: a thorough education of your condition, your options, desires, realistic expectations, and a personalized treatment plan. All of your questions will be answered and your concerns addressed. Dr. Rudderman has done hundreds of breast surgeries and can project your likely outcomes. From the consultation evolves…trust, respect, mutual understanding, and a personalized treatment plan.

These treatments are not an emergency, and plenty of time will be allowed to have a full conversation to consider options. Additional visits can be provided until you feel confident that you are making the best decision for yourself in health, safety, and outcome.

Dr. Rudderman has done hundreds of breast surgeries and can project your likely outcomes. From the consultation evolves…trust, respect, mutual understanding, and a personalized treatment plan.

After your first consultation with Dr. Rudderman, you will realize that there truly is a difference in how surgeons approach their profession. For Dr. Rudderman…that difference means understanding your goals AND providing a level of service that places safety & comfort alongside predictable and pleasing outcomes.

Contact us at 678.566.7200 to meet with Dr. Rudderman in our Alpharetta or Midtown Atlanta offices.

Written and reviewed by:

This article was written by Dr. Randy Rudderman, who is board certified by the American Board of Plastic and Reconstructive Surgery (1994). He practices medicine at his offices in Alpharetta and Atlanta.
Learn more about Dr. Rudderman, his medical training, and credentials.

Post Surgery Expectations

  • You will wake up with a small dressing over the treated area and a surgical bra –
  • Mild swelling, & some discomfort is normal & to be expected – this resolves on its own and often requires only acetaminophen
  • You will be seen in the office 24 hours post-surgery and given a more comfortable bra
  • Swelling generally is mild and resolves in 1-2 weeks
  • Sutures are absorbable and do not need to be removed
  • You will have a type of brown paper tape on the incisions to protect the area and help with minimal scar formation
  • Most patients who have surgery on Thursday can return to desk work Monday
  • Avoid strenuous activity for 3 weeks…Dr. Rudderman will tell you when you can start to exercise again
  • Measurable results are typically visible immediately, but be patient as healing and stabilizing takes time. It can take months for the “new you” to be clearly seen.

Long-Term Results

The results of this procedure are long-lasting. The areola can naturally widen over time but it is not common to need additional surgery for many years if ever. Areolas may not be totally symmetric due to the normal contractile nature of the tissue and can change by the minute, under different stimuli, and are rarely always round.

Areolar Reduction FAQ’s

What is AREOLAR Reduction surgery?

Areolar Reduction surgery involves reducing the size (diameter) of the areolae (the pigmented part around the nipple). Areolas may be enlarged during puberty and breast development, and frequently become enlarged after pregnancy. Areolas often are asymmetric in shape and size when enlarged.

Why treat enlarged areolar?

Enlarged areolas often make the breast look unbalanced, and older than your actual age. Enlarged areolas can be associated with a puffy appearance with the areola more prominent than the remainder of the breast. Enlarged areolas that are significantly asymmetric in some cases may be associated with a tubular type breast. Enlarged areolas can be problematic in clothing and difficult to cover in some bathing suits and work out clothing.

How is Areolar Reduction surgery done?

Precise incisions are made to reduce the excess tissue of the areola and to improve the position and symmetry of the areola as well as shape the areola to a more youthful and appropriate size relative to the breast. Absorbable sutures are used to complete the surgery. A light dressing for cover is applied. The resulting areola typically heals with minimally visible incisions. Most all areolas have some contractile tissue that when stimulated may change the shape of the areola. This action is normal, and may be more visible in some patients. This effect can be discussed during your consultation.

Will areolar reduction surgery effect sensation in my nipples?

Removal of excess areolar tissue rarely impacts the nipple sensation.

Will I be able to breast feed after Areolar Reduction surgery?

The areolar tissue does not contribute to breast milk during breast-feeding and areolar reduction alone will not impact your ability to breastfeed. However each pregnancy is different and no one can predict whether or not you will be able to breast feed during a future pregnancy

Will I have a board certified anesthesiologist for my Areolar Reduction surgery?

Yes. All cases are supervised a Board Certified medical doctor who has specialized in anesthesiology.

Does Dr. Rudderman perform the entire Areolar Reduction surgery?

Yes, he performs all of his patient’s surgeries. Many surgeons use assistants to suture or perform part of the operations. Dr. Rudderman performs the entire operation on every patient.

Is the surgery done in an accredited facility?

All of our surgeries are performed in a fully accredited surgery facility using state of the art technologies and a world-class staff with all the comfort and safety factors as a hospital surgery suite.

Will there be any pain with Areolar Reduction Surgery?

All surgeries involve some discomfort. Dr. Rudderman is highly skilled and uses advanced techniques and refined instruments that maximize comfort during his surgical procedures. Many patients will take Tylenol only, however some pain medications may be taken for relief for1-2 days after surgery.

How will I look after Areolar Reduction Surgery?

Most patients will look close to normal right after surgery. Some patients may look nearly fully normal as the incisions healing process continues during the first few weeks following surgery. Most incisional scars continue to mature and improve over a 9-12 month time frame.

How long before I can exercise after Nipple Reduction surgery?

You will need to avoid all rigorous, strenuous activities for a 1-2 weeks until healing is adequate and Dr. Rudderman tells you it’s ok. Aerobic exercise increases your heart rate and blood pressure and can cause the operated area to swell delaying your healing. We will see you frequently during your healing process to help you return to your normal activity as soon as possible. Exercise can be an important part or recovery, and we follow your recovery closely to help you reach your goals.

How long before I can return to work after my Areolar Reduction surgery?

Dr. Rudderman’s patients most often return to desk jobs the next 1-3 days. He can give you a time frame specific to you during your consultation.

Will insurance pay for Areolar Reduction surgery?

Areolar reduction surgeries are considered to be cosmetic procedures. Cosmetic procedures are not covered by insurance.

Is financing available for Areolar Reduction Surgery?

Yes. Financing is available through Care Credit for all the breast procedures Dr. Rudderman performs.

Will I need someone to take care of me after my Areolar Reduction surgery?

You will need someone to drive you to and from your surgery, stay during surgery and remain with your overnight (24 hrs) after you have had anesthesia. Your follow-up visit will usually be within 24 hours, and you should be able to drive to this appointment if you are not taking pain pills.

  • Dr. Rudderman and his staff made the experience easy and comfortable. They were realistic communicating surgery expectations, expected pain levels and down time from work. Nurses were informative and friendly and wait times minimal. I also liked the fact that Dr. Rudderman does all his own work and doesn't let other less experienced people do parts of the surgery the way other doctors may. I'm only one week out of the surgery, but I am very satisfied with the results so far.

    Susan Parker | Atlanta, GA


Dr. Rudderman’s unique, integrated approach to plastic surgery employs only safe, effective, predictable surgical techniques that are driven by uncompromising respect for the natural condition of the human form. He understands that the body changes with time – as do desires. His primary goal is to deliver the best possible plastic surgery … specifically matched to each patient…in a safe environment with ultimate respect for every single individual…their concerns and goals. LEARN MORE »

“The best plastic surgery results must give each individual the opportunity to feel comfortable now and in the future…”

Dr. Randy Rudderman

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