In the majority of cases, the chest skin will spontaneously tighten after the excessive tissue beneath (breast and/or fat) has been removed in the course of surgery. Since the nipple/areola is also a skin structure, it too will tighten and diminish in size. In fact, the average areolar shrinkage is about 15-20%. The areola will also darken somewhat in color after surgery. Hard to imagine this? Just think of a balloon with a circle drawn on it. Then let some of the air out — the circle (think of the areola) will be smaller. One added bonus: if an incision has been made in the areola to help remove glandular tissue, the resultant scar will also shrink in size.
In rare cases, when the areola is extremely large, surgery can be performed to reduce it to a more appropriate size. It requires a permanent suture to be placed under the skin to prevent post-operative spreading of the areola. The surgery requires an incision completely around the edge of the areola. Post-op problems can include spreading of the scar, distortion of the areolar contour and the possibility that one could feel the permanent circular suture under the skin.
