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Donut Mastopexy

(AKA Circumareolar Mastopexy or Areolar Reduction)

A woman holding two donuts represents a play on words for donut mastopexy.

Guess which tool plastic surgeons use when performing a donut mastopexy:

A) A rolling pin

B) A flour sifter

C) A cookie cutter

D) None of the above

Believe it or not, the answer is C! We truly do use a cookie cutter, or at least that what it’s called because it would be perfect for making nice, round, areola-sized butter cookies.

But instead of making impressions into cookie dough, we use our cookie cutter to design nice, round areolas. But that doesn’t explain what a donut mastopexy is.

What Is a Donut Mastopexy?

The graphic video meant for an audience age 18 and older explains the procedure with before-and-after photos along with some views from surgery.

A Donut Mastopexy is a surgical procedure that usually accompanies a breast augmentation.

Although there are variations of the procedure, the original version is to take a ring of skin from the outside of an areola, place a running suture back and forth all around the skinless gap, and cinch it tight like a purse string.

Still mystified as to why it’s called a Donut Mastopexy? To a hungry plastic surgeon long ago that round ring of skin looked like a donut. (You probably just lost your appetite!)

However, despite the name, the skin removed isn’t always a round ring. Its shape depends on the goal of operation, which brings us to why we do this procedure.

What Can a Donut Mastopexy Accomplish?

A Donut Mastopexy is most commonly performed to improve these four breast conditions:

1. Slightly low nipples

2. Nipple-areolar asymmetry

3. Large areolas

4. Puffy areolas

Slightly Low Nipples

If the nipples are less than about an inch below the level of the breast crease, a Donut Mastopexy is effective in scooting the nipples up a bit. If the nipples need more than just a little scoot in the upward direction, more skin needs to be removed, and a more extensive breast lift is indicated, resulting in a lollipop or an anchor scar.

Because a Donut Mastopexy yields only a slight nipple lift, the procedure is rarely done alone. Instead, it usually accompanies a breast augmentation. The round contour of the breast implants can exaggerate the low position of the nipples, but a Donut Mastopexy can bring them up facing forward so they look rejuvenated.

Confused? Then let’s do a little demonstration. Get two oranges, and place a  small round sticker on each. Rotate one so the sticker is angled slightly downward, and keep the other looking straight ahead. The downward facing sticker isn’t just lower, it’s angled downward. A Donut Mastopexy can scoot the low-lying nipple to the higher level of the straight-ahead sticker.

Nipple-Areolar Asymmetry

Nobody’s breasts match, except for a Barbie Doll’s. One areola may be lower, or bigger than the other. By raising the lower areola’s position or decreasing the larger one’s diameter, a Donut Mastopexy can create a better match. If one areola is well positioned with a pleasing width, it remains undisturbed while serving as model for the other during a single-sided procedure.

Large Areolas

When areolar size reduction is the goal, the level of the nipple may change very little, depending on the goals of the operation. A Donut Mastopexy is often done at the time of a breast augmentation in women with large areolas to avoid further areolar stretching.

Puffy Areolas

Women with areolas that puff out like marshmallows usually have a condition called tuberous (or tubular) breasts. The soft, puffy tissue beneath the skin is breast tissue. A Donut Mastopexy can reduce the projection by tightening the skin.

A Single Scar

While a Donut Mastopexy may be done for different reasons, the resulting scar is the same: a line around the areola. Typically the scar is pink for a year, plus or minus six months, and then it fades.

The “Straight Man”

While a Donut Mastopexy gets little attention in the lay press, it’s like a good straight man in a comedy act. The funny guy, like a breast augmentation, may get all the attention, but without the straight man, the act wouldn’t be nearly as good.

The Donut Mastopexy, when indicated, makes a breast augmentation shine.



Dr. Heather Furnas

About Dr. Heather Furnas

Inspired by watching her plastic surgeon father operate in African bush hospitals, Dr. Heather Furnas followed in his footsteps, training at Stanford and serving on the Harvard clinical faculty. She and her husband, Dr. Paco Canales, practice together in Santa Rosa, California, where they raised their two children. (To learn more about their practice, visit She believes an informed patient is more likely to be a happy patient and is committed to providing that education. If you have any suggestions for topics you'd like to learn more about, she would love to hear from you!

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7 Responses to Donut Mastopexy

  1. Jenna Pearson says:

    Great information. There are so many options when considering a Donut Mastoplexy!

    • Dr. Heather Furnas says:

      So glad you enjoyed it. Yes, a Donut Mastopexy can really be helpful in maximizing results in patients who are good candidates for it.

  2. kia says:

    Hiya I just want to know a price to get my nipples smaller and a boob job . Thank u xx

    • Dr. Heather Furnas says:

      A breast augmentation generally runs around $6,000 to $8,500, depending on the geography of the practice and the surgeon. A nipple reduction or an areolar reduction done at the time of a breast augmentation adds a variable amount to the procedure, ranging from about $1,500 to $2,500 or more, depending on the specific procedure, geography, and the plastic surgeon.

      As you search for a plastic surgeon, look for someone who is board-certified specifically in plastic surgery as a minimum requirement, and choose someone with good before-and-after photos. While price is always a consideration, it shouldn’t be the basis of your decision on whom to choose to do your surgery, as you can read here.

  3. Shtara Richard says:

    How much would aerola reduction and moving the nipple up a little cost?

    • Dr. Heather Furnas says:

      The cost would depend on whether the donut mastopexy were done in combination with a breast augmentation or by itself. It would also depend on the geographic region and the surgeon.

      When done in combination with a breast augmentation, the range is about $1000 to $2500. When done alone, the range would be a little higher, about $1500 to $3500.

  4. Pingback: Rejuvenating Sagging Breasts | Plastic Surgery in Santa Rosa: Blog :

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