The areola is the pigmented skin around the nipple. The size and shape of the areola vary not only from woman to woman but may vary from one’s right to left breast, as every breast is unique. With pregnancy, hormonal change, weight change, the areola can increase in size and change in shape. Areola reduction, reducing the areola size and improving the shape, can be performed as a stand-alone procedure or in combination with breast procedures such as breast reduction, breast lift or breast augmentation.

When performed as a stand-alone procedure areola reduction can be performed as an office procedure under local anesthesia. The procedure may be referred to as a “donut” excision or donut mastopexy. Two concentric circular incisions are made. The outer incision is made at the junction of the pigmented areolar skin and the non-pigmented breast skin. The inner circular incision will become the new outer border of the reduced areola. The areola skin between the inner and outer circles is the skin that will be removed. Stitches are then used to close the incision bringing the concentric circles together reducing the size of the areola and improving the shape.