Both my nipples are not longer centered faceing outwards? Is this normal and can it be corected? I want to have larger implants put in but I do not want this to occur again.
Nipples Facing Outwards 2 Years After Silicone Implants. Will This Recur w/ Revision?
Doctor Answers (13)
Medial crescent pexy to correct nipple position
Outward nipple position can be exaggerated after breast augmentation. This can sometimes be corrected by repositioning the implant. However, the easiest way to improve the nipple position is to remove a crescent of skin on the inside of the nipple-areola complex to "pull" the nipple more inwards. (medial crescent pexy). This leaves a small scar around the inner border of the areola which usually heals very well being in the margin of the areola. Nipple sensation should not be affected. This could easily be done at the same time as your implant exchange.
Nipple position facing outwards
It is both critical and knowable to determine whether the cause of outward pointing nipples is because of natural conditions or because of implant malposition. Properly sized, positioned, and healed breast implants should never change the axis (direction) the nipples point. A revision with an implant change will require a new assessment of proper sizing, positioning, and healing to correct the outward pointing nipples if they were due to implant malposition or to leave them the same if the problem was there before the first procedure.
Nipple position after breast augmentation
Nipple position may vary prior to surgery. After surgery, depending on the position of the implant, the nipple may appear to point more laterally. Positioning of the implant a bit more laterally may help the nipple come in a bit, but then your breasts and cleavage may be too wide. Repositioning of the nipple can be accomplished with some moderate scarring.
Wishing you all the best,
Tal Raine MD FACS
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Nipples facing outwards
I have reviewed the comments of my colleagues and agree with almost everything they have said. The bottom line is, it depends on the specific factors of your case. I will add 2 more thoughts. I have seen lateral positioned/pointing nipples in sub glandular augmentations, that are corrected with submuscular placement. These cases have been associated with capsular contracture and implant displacement, which may be the cause of your problem. High profile implants, because they are narrower, may be placed more medially to give the appearance of greater cleavge leading to a more lateral appearing nipple. This can usually be corrected with wider implants. Even if your nipples did point to the side before your 1st surgery, it should be possible to improve the position/appearance with a subsequent surgery that is tailored to fit your specific issues. Just be open minded when you are having your PS consultation.
Check the before photos to see the original position of your nipples. It may not be possible if they are in a certain position. Understand that the key to breast implant surgery is to get the implant centered behind the nipple.
Sometimes the direction, not the position, of the nipple can be altered by placing the implant more toward the middle of your chest to turn the nipples out and placing the implant more toward the outside of your chest to turn the nipples in.
This can work sometimes, but not very often.
Your before surgery photos will indicate if this was already present and to what degree. If yes, then increasing your implant size may not correct this.
Outward pointing nipples
A lot will depend on what you had pre-op. If your nipples pointed outward prior to surgery then putting in an implant may accentuate this. A wider implant may improve the appearance but it is hard to tell without photos. Before proceeding with surgery I would discuss this with your plastic surgeon.
Nipple Position after Implants
Your anatomy, your implant choice and the surgery that you had, can all affect your nipple / areola position with implants. If you post before and after pictures, we may be able to give you more specific advice. If it is just a matter of properly centering your implants under your nipple / areola, you can possibly have better position and symmetry. If you have ptosis (or looseness of your breast), then you may need a mastopexy at that same time as your implant revision. In this case, the nipple / areolar complex can be moved into better position during the surgery.
Nipples facing outward after augmentation, is it correctable?
It is difficult to answer your question without photos (both preop and postop). Was this a gradual drift outwards or they looked like now initially after surgery? As a general rule, if your nipples are far apart prior to surgery, they will tend to move even more laterally with an augmentation. If you are going to get larger implants, the nipples will tend to go even more laterally. Imagine what happens if you place two dots on a balloon and then inflate the balloon. You need to discuss this with your plastic surgeon before your planned surgery. Good luck.
Outward facing nipples
This is caused by many factors. Implants can be too big or too small causing the nipple-areola complex to be not centralized on the breast mound. The implants can be inadvertantly malpositioned medially thus putting the nipple more towards the outer half on the resulting breast mound. Finally, patients can begin with nipples that are facing a certain direction and this is accentuated with implants. A careful analysis and discussion regarding natural anatomy and goals should prepare you for this possibility and for options to correct it.
Robin T.W. Yuan, M.D.