If the Areola Shape Looks Like Panda Eyes After Breast Reduction

If we talk about the things people are dissatisfied with after breast reduction surgery, they can broadly be divided into two categories: dissatisfaction with size and dissatisfaction with shape.

As breast reduction surgery has become more common, surgical techniques have also matured, and patients’ expectations seem to be rising accordingly.

While other complaints are decreasing as surgery continues to improve, dissatisfaction with shape is actually increasing.

Rather than simply wanting to have the surgery done, more and more people today are making detailed aesthetic requests.

Because breast reduction surgery has become more widespread, the proportion of women in their 20s and 30s is increasing.

The younger the patient, the more emphasis they tend to place on shape rather than size.

Recently, among these shape-related complaints, more people have been asking for revision surgery because they are dissatisfied with the shape of the areola.

To summarize complaints about areola shape after reduction surgery: immediately after surgery, the areola is small and round, but over time it gradually widens and often takes on a large, outward-drooping shape like panda eyes.

Today, let’s take some time to look at why this happens,

and what the causes and improvement methods are.

In fact, changes in the areola over time after reduction surgery are difficult to avoid.

Because the outer side, where there is more glandular tissue, has a heavier structure, the areola tends to become elongated at a 45-degree angle like panda eyes over time after surgery rather than maintaining a round shape.

For this reason, many medical professionals have long recognized this phenomenon and have tried to prevent it.

For example, they would design the areola in a mushroom-head shape rather than making it perfectly round to prevent this outcome in advance.

Some medical professionals did not pre-design the skin to be removed around the areola, but instead, at the very last stage of the surgery, with the patient sitting up, they would design and excise the areola area in a round shape.

Through processes like these, areolar deformity has improved significantly.

However, recently this type of areolar deformity has been appearing prominently again, and in some cases it is even more severe than in the past.

It is usually seen often in people who have undergone vertical incisions.

What is strange is that areolar deformity is not a characteristic side effect of vertical incisions.

The reason this phenomenon is especially noticeable only in recent vertical incision cases is that a different approach from the original vertical incision technique is being used.

The original vertical incision method is closer to a lollipop shape.

Simply put, it has a small areolar circumference and a long vertical scar.

Therefore, a drawback is that the lower part of the vertical scar may extend beyond the inframammary fold, or the vertical incision line may need to be gathered and closed at the fold area, which can create unsightly wrinkling.

However, at least the basic principle of breast reduction surgery—closing the scar around the areola neatly—has been well maintained.

That is because the areola is the most protruding and visible part of the breast.

In contrast, the vertical incision method that is currently in fashion is like a large cotton candy, with a big upper portion and a short handle, and it is characterized by a wide excision around the areola in order to reduce the vertical scar.

If this is done, a large difference in diameter occurs between the areola and the surrounding skin.

This is similar to tightening and suturing the skin toward the areola, much like the method used in periareolar incision surgery.

Therefore, this can be seen not so much as a vertical incision method, but rather as a modified form of a periareolar incision method.

When surgery is performed this way, the vertical scar is clean, but unsightly wrinkles form around the areola.

These wrinkles gradually sag over time, but they do not smooth out on their own.

The wrinkles are caused by tightening together skin with a large diameter and an areola with a small diameter, like a money pouch.

However, the elasticity of the areola’s dark skin and ordinary skin is fundamentally very different.

The areolar skin contains muscle and stretches well, so if the surrounding skin with a larger diameter is pulled toward the more elastic dark areolar area and sutured there, the dark areola cannot easily withstand it.

As a result, instead of the surrounding skin becoming narrower, the areola widens and the wrinkles flatten out.

As evidence of this, the areola, which was originally dark, gradually turns a pale brown, and the wrinkles or small bumps that should normally be present in a healthy areola become flattened and disappear, transforming the small and round areola into a larger one that droops outward like panda eyes.

The reason this surgical method emerged is because the era of photographs has arrived.

In particular, because the most important parts—the nipples and areolas—are mosaicked for pre-screening reasons, the importance of areolar scars is fading, and the surgery is becoming distorted into a method focused on how it looks in photos.

However, just because something is not visible in photos does not mean it is not visible in real life.

So how can we improve areolas that have become enlarged like panda eyes?

A simple method is to remove the upper and lower parts of the areola that have stretched at a 45-degree angle, but in the long term, even doing this will not reduce the enlarged size of the areola.

This is simply performing the same type of surgery once more, and the areola will stretch again.

Ultimately, such large and stretched areolas can only be treated by addressing the root cause.

Therefore, if the circumference of the surrounding skin is reduced and the scar is converted to a vertical or inframammary fold scar, it can be restored to a normal areola again.

But more importantly, please remember that when the initial surgery is performed, taking areolar tension into account is what prevents areolar deformity.