Technique for areolar reduction areolar-sparing mastectomy

Achieving satisfactory nipple esthetics following skin-sparing or nipple-sparing mastectomy is an important element of ensuring positive patient outcomes. Several techniques used to reconstruct the nipple-areolar complex have been described in previous literature and have had success in securing good cosmetic outcomes. For patients with macrothelia, surgeons may employ a number of options in reducing nipple size. Existing studies have shown common preferences among individuals surveyed regarding breast cosmesis, specifically related to the nipples and areolae. However, for individuals with disproportionately large areolae following areolar-sparing mastectomy, there is scant literature to suggest methods of reducing the size of the areolae, and current practice appears to be based upon fixed diameters of areolar sizers. In this technical report, we describe a suture-only technique that successfully reduced areola diameter and recreated the appearance of a nipple with a small central projection following areolar-sparing mastectomy.