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Areola Reduction

Large areolas may look out of proportion with the rest of the breast - especially if the patient has had a breast reduction or breast lift, but it happens naturally as well. The areola darkens after the second month of pregnancy and usually enlarges as pregnancy progresses. Some women's nipples are inverted, or turned inward. Some women feel their nipples protrude too far. For others, the problem is areolas that are too big or too puffy. No matter what the problem is, the solution is almost always a simple procedure. There are no medical complications from having large areolas, so the desire to reduce the areola is purely cosmetic, but can really positively affect the patient's self-esteem and body image. 

The procedure used to reduce the size of the areola is usually a modified mastopexy procedure. In fact, a lift is often integrated into the procedure, since the incisions are very much the same. This type of procedure is called a Benelli lift, Donut mastopexy, modified mastopexy or periareolar lift. In essence, a symmetrical circle of areola skin is excised and the breast is sutured to produce a smaller areola and a slight lift effect. Occasionally, the skin is removed at the very base of the nipple rather than the outer circumference of the areola, depending on the particular physical characteristics of the patient. 

Why Naravee? 

Simply put, the Naravee Aesthetic Center in Bangkok, Thailand is one of the world’s finest plastic and cosmetic surgery centers. Our doctors have been trained all over the world and have medical knowledge comparable to anyone in the field from the rest of the planet. We offer you five star facilities and results with the beautiful city of Bangkok, Thailand on the horizon. You receive all of this for a fraction of the cost of the same procedure in Europe or America.




Areolar Reduction 
Package 7.2 

Price: Refer to pricelist* 
* Prices are subject to change without prior notice. 

Package Includes 

Preoperative consultation and care. 
Room charges: Operating room use, Recovery room, Scrub & Circulate Nurse 
Accommodation for three days and two nights: Room, Nursing service charges, Other service charges and meals (if allowed by surgeon). 
Medical equipment and medical supplies necessary for the procedure. 
Anesthesia: Pre-anesthetic drug, Anesthetic Medical Gas. 
Medication: Routine medication used for the procedure and during admission only. 
Doctor fees: Surgeon fees, Anesthesiologist fees. 

Package Excludes 

Charges for other procedures or other plastic surgery procedures. 
Outpatient fees and expenses incurred before admission if required, e.g. EKG, laboratory testing (CBC, PT&PTT, Urinalysis, Anti HIV), chest X-ray. 
Other charges for laboratory profiles and medications not related to the procedure.
Other charges not related to the procedure. 
Items of a personal nature such as in-room soft drinks and telephone charges will be charged at standard rates currently applicable. 
Take home medications and supplies. 

Patient Eligibility 

The package is applicable for elective, uncomplicated patients. Patients with the following conditions are considered to be complex or high risk cases and will not be qualified for the package: 

Bleeding Disorders. 
Patients with underlying severe medical problems that require additional treatment and investigation including, but not limited to HIV and uncontrolled diabetes. 

About the Procedure

Preoperative Condition:
Breast Hypertrophy (causing painful strain on the neck, shoulder and back).
General Anesthesia.
Surgical Planning
The surgeon will conduct a routine breast examination and depending on your age and family history, may determine that mammograms or breast x-rays are required. After examining you, the surgeon will discuss other variables that influence the decision involved in reduction mammaplasty such as the size, shape and skin tone of your breasts. Since the ability to breast-feed following reduction mammaplasty is unpredictable, you should discuss the matter with your plastic surgeon at this time.
Surgical Procedure:
Reduction mammoplasty is typically performed to reduce disproportionately large, sagging breasts. It also can reduce the size of the areola (the dark pink skin enlarged as the breast develops).

The choice of operation will depend on the degree of hypertrophy and the amount of breast removal. Periareolar breast reduction is suitable for minimal amount of breast removal. Vertical incisional line is drawn around the areolar margin and extend downward inferiorly towards the mammary crease. Horizontal extending incision from the vertical line is the choice for bigger breast and more volume breast reduction is anticipated. Still there are a number of modifications of operations to suit with the different type of hypertrophic breast.
The most commonly employed technique, called brassiere pattern skin reduction, involves both horizontal and vertical incisions that follow the contour of the breast. The vertical incision creates a key hole-shaped pattern above the areola. Working through the incisions, the surgeon excises excess tissue, fat and skin on the sides of the breast. Skin is removed from the area within the vertical incision and around the areola. The nipple, areola and underlying tissue are moved through this space to a new higher location.
Another technique involves completely detaching the nipple from the breast before relocating it. Since a transplanted nipple loses all sensitivity, this approach is performed only when deemed necessary for patients with extremely large breasts. After the nipples are repositioned, skin on both sides of the breast is moved down and around the areola and then brought together to recontour the breast.

Sutures close the wounds under the breast and around the nipple area. Following surgery, a gauze dressing may be applied to the breasts or the patient may be placed in a surgical brassiere.
Duration of Operation:
Five to six hours.
Four days and three nights.
Smaller, more comfortable breasts. Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it is important to remember that reduction mammoplasty scars are extensive and permanent. They often remain lumpy and red for months, and then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.   
Postoperative Care: After surgery, you will be wrapped in elastic bandage or gauze dressings and a surgical bra. A small tube may be placed in each breast to drain blood and fluids for the first day or two. The extent of the post-operative swelling and bruising is dependent on whether you tend to bruise or swell easily. The amount you can expect varies for each individual but past surgery or injuries should be a good indication. Applying cold compresses or ice packs will reduce swelling and relieve discomfort. Many patients use watertight plastic sandwich bags filled with frozen berries or peas. Regular icing is the key to relieving swelling.
The bandages will be removed a day or two after surgery, though you will continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subsides. In most cases, stitches will be removed in one to three weeks. Sometimes the surgeon will use only dissolvable sutures. If breast skin is very dry following surgery, moisturizer can be applied several times a day, but the suture area must be kept dry at all times.
Swelling and skin discoloration around the incisions generally will subside in a few days. After surgery, there may be a temporary loss of sensation in the nipples and breast skin. If it occurs, this condition will improve with time. Sutures will be removed within two weeks after surgery.

Although the surgeon makes every effort to keep scars as inconspicuous as possible, reduction mammoplasty scars are extensive and permanent. The patient must be willing to accept the change from large uncomfortable breasts without scars to small comfortable breasts with scars. Scars remain highly visible for a year following surgery then fades to some degree. Since incisions are made around and below the nipples, scars should not be noticeable even in low-cut-clothing.

To permit proper healing, you should avoid excessive exercise and refrain from heavy lifting for three to four weeks. The decision on returning to work and normal activities depends on how fast you heal and how you feel.
It is important to follow a careful plan on returning to strenuous activity, in order to avoid tension on the wound (which could lead to worse scarring).
Keep your bandage clean and dry. Sponge bathe only. You will remain in bandages for about one week. Light activities can be resumed within a few days. Routine physical activities and exercising (especially lifting, pulling) should be avoided for at least six weeks. Empty and record the drains three times a day. NO SMOKING for two weeks after the surgery.
Road to Recovery: The recovery takes one to two weeks. Most people are back to work in two to four weeks. Strenuous activities can resume within four to six weeks.

The possible risks of surgery are divided into two groups. First, those that are seen in all operations and second those that are unique or special for a particular operation. In the first group, the main risks are swelling, bruising, bleeding, infection, a scar and numbness or change in sensation. The main problem, which is unique to this operation, is damage to the blood supply of the nipple and a heavy scar.

Postoperative complications, such as delayed healing, infection or localized collections of blood are uncommon. Poor healing may necessitate subsequent scar revision. Risk of complications can be minimized by closely adhering to your surgeon’s advice on follow-up care during healing process.

Breast-feeding may not be possible after surgery.

Breast reduction does NOT increase the risk of breast cancer and indeed may slightly decrease the risk.


Prepare for Surgery 

Send via email or fax three photos showing the following views: the frontal, the lateral and oblique views. Use a dark or black background whilst taking the photos. Prepare yourself by being as fit and healthy as possible prior to the procedure. Check your blood pressure and cardiac status, e.g. EKG, especially those who are over forty years old. Avoid some medication such as ASA and vitamin E medications, etc. for two weeks prior to operation. Consult with your local Doctor. Refrain from smoking and drinking alcohol two eeks before and four weeks after surgery. Purchase a "post-op" bra support prior to surgery, the bra may or may not have been applied. Plan to be in Thailand ten days altogether.



Naravee Aesthetic Clinic:16 Udom Suk Soi 30,
Sukhumvit 103 road, Bangna 10260 Thailand

Mobile: +668-4499-4470
Fax:+66-2398-8565 Ext. 425