9 Days Post BA and TT. Are My Breasts Dropping Properly and is Left Areola and Nipple (photo)Offcenter Compared to Before BA?

Question

9 days ago I had BA with 435cc silicone implants and a TT with hernia repair. Are my breast dropping properly (left side a bit higher) and is the left areola and nipple offcenter compared to the pre surgery photo (nipple was offcenter before BA but not areola?) How do they look overall so far? In the photo I am hunched over but know I will need a breast lift in the future.

Gerald Minniti, MD, FACS · Answer

Hello Ana,

	The asymmetry of your areolae can be easily explained by the pre-operative appearance of your breasts.  Your left breast was slightly larger and the distance from the chest wall to the areolar edge was greater on the left, so after the augmentation your left areola moved more freely and further to the left.  In addition, the left implant is slightly higher, accentuating this asymmetry more.

	A more concerning problem is your overall breast appearance, specifically your nipple position relative to the breast mound.  I'm a little more dubious than the other doctors about how far your implants will drop, and therefore how high your nipples will come up.  If you look at and compare the lateral views pre and post surgery, you will see that your nipple position actually dropped. This can be confirmed by looking at and comparing the front views. In the preoperative photo there is a thin strip of your breast skin that is visible below your areolae.  In the postoperative photo you cannot see the bottom of areolae because it has rotated downward.  You are a good example of a point I make on Realself.com over and over again: large breast implants will not give your breasts/nipples a lift, no matter how large the implants are, and in fact can make the appearance of the breast and position of the nipples slightly worse.

	As I've said there will be some improvement, the question is will you be satisfied with the relatively low nipple position you will most likely end up with.

	Best of luck!

Pedro M. Soler, Jr., MD · Answer

Thank you for the photos. You are merely 9 days into your healing, so I would caution you told hold off on making any decisions about your results. At this point the breasts are inflamed and actively scarring. During the next 3 to 6 months, or longer, the swelling and the scarring process will begin to subside and the soft tissue envelope will stretch and accommodate. This will allow your implants to fall into the desired position, filling the breasts and lifting the nipples, changing the appearance of your breasts significantly. Please know that these changes may not occur at the same rate in both breasts.

	Continue to follow up closely with your plastic surgeon. He will help guide you through your recovery in order to achieve the desired result. I hope this helps.

	Good luck.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	 I can appreciate the concerns you have about the position of a nipple/areola complex on the left breast mound.  However, considering that you are only 9 days out of surgery, it is much too early to evaluate the results of surgery. For example, you may find that the position of the nipple/areola complexes will change significantly over the course of the next few months, as the breast implants settle.

	I would suggest that you continue to follow-up with your plastic surgeon  and follow all of his/her instructions that might help the breast implants “settle”.

	Best wishes.

Jourdan Gottlieb, MD · Answer

The breasts were not exactly even before surgery, and without a lift they are not going to be afterwards. Any asymmetry is usually more noticeable with larger breasts after augmentation. 

	The implants look quite even. Any asymmetry of areolar position would be corrected at the time of breast lift. 

	Thanks and best wishes.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and photographs.  You will continue to improve significantly after 9 days postop.   If after 3-6 months you are still unhappy with the position of your nipples a breast lift may be done as a second procedure.  Many surgeons feel that breast lift should always be done as a second procedure after breast augmentation.  Please discuss your concerns with your plastic surgeon, but for 9 days I think you look very good considering the preop appearance of your breasts.

9 Days Post BA and TT. Are My Breasts Dropping Properly and is Left Areola and Nipple (photo)Offcenter Compared to Before BA?

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