Asymmetrical Breasts and Inverted Nipple Correction (Photo)

Question

I have had asymmetrical breasts since I was around 14 years old. I began developing breasts and nipples at age 9. Sometime later, my nipples began to invert and had to see a doctor from bruising. I’ve had inverted nipples ever since, however when stimulated, the left comes out. Based on the pictures provided, will I need a breast lift? If so, is a Benelli lift an option? Saline or Silicone best to fix asymmetry? Will inverted nipple correction fully correct the problem? Pricing?

Christine Rodgers, MD · Answer

HI jena,First of all, I think that surgery can help with your asymmetrical breasts. I think that silicone implants will give you more options as they are more flexible and tend to fit better in different shaped breasts. I also think that you will do better with a lollipop mastopexy or lift. A Benelli can raise the nipple areola complex, but, in time, the breast tissue will fall below it without the lollipop lift This type of lift will tighten the tissue in the bottom part of the breast and keep it in a more youthful position for a longer period of time.Typically, the inverted nipple can be corrected at the same time, but it is important for you to be examined by a plastic surgeon first. Sometimes, if a nipple cannot be extruded, it may be difficult to have symmetrical and equally sized nipples.In any case, you should visit with a Board certified plastic surgeon in your area who does a lot of these procedures to get an in person exam and to discuss all your goals and options.Best Wishes,Dr. Christine Rodgers

Gregory A. Buford, MD, FACS · Answer

As a Board Certified Plastic Surgeon who specializes in both primary and secondary breast surgery, I can tell you that this is a little more complicated than a standard enhancement.  You will most likely require a lift to the right side to address nipple position and lower position overall of the right breast.  A peri-areolar lift can work but this is associated with a high rate of stretching of the areola over time and so I would also lean more towards a lolli-pop incision as described below.  This is a case best left to a Plastic Surgeon experienced in this type of procedure.  Suggest that you meet with a Plastic Surgeon and discuss your concerns and price at that time.  I hope that helps and wish you the very best!Warmest regards,-Gregory A Buford MD FACSBoard Certified Plastic Surgeon and Author

Daniel Barrett, MD · Answer

Dear Jenaex,based on your photos, you have a significant asymmetry and you will most likely need a breast lift in order to achieve symmetry. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Shelby K. Brantley, Jr. MD · Answer

Hey Jenaex!  I think you make a great candidate for a breast lift on the right breast and an augmentation on the left.  It will be up to your chosen surgeon, but you may only need a mini lift on the right.  You have to always keep in mind that the surgeon will still be matching and apple to an orange and not two apples to match.  So, make sure and choose a surgeon that is very familiar with doing asymmetric work.  A great surgeon chosen will know exactly what to do :).  I would recommend gel implants. I love them and recommend them often.  As far as your nipple inversion correction, depending on the tension from the augmentation, this may or may not be able to be done at the same time as your surgery.  You should end up with a great matching pair! Good luck!

Tom J. Pousti, MD · Answer

Thank you for the question & pictures.  Based on your post, I think that you have a good understanding. Breast lifting ( possibly Benelli breast lift will suffice but this will depend on careful physical examination and the communication of pros/cons associate with each type of breast lift) will likely be necessary on the larger/lower side.  Both saline and silicone breast implants are good options;  in my practice, I individualize the type of breast implant utilized based on factors such as patient's body type and desired outcome.  You will read a lot about the pros/cons associated with each type of breast implant on the real self website. When it comes to cost of surgery, there may be many “variables” involved. The  specific operation planned, the surgeon's credentials/experience level (or lack thereof), the specific geographic area you are looking at, the different operations available, the location of the procedure ( quality of surgery facility), type/quality of anesthesia provider, type of breast implants… are some of the potential variables involved. You will find average costs of surgery listed on this website, and on individual plastic surgeon's websites as well.Usually correction of the inverted nipples involve division of the lactiferous (milk ducts).  Often, this procedure can be done at the same time as other types of elective breast operations are being performed; sometimes, it is better to perform the nipple inversion correction at a second stage (blood supply and healing considerations come into play in some cases). Risks of the procedure include potential loss of sensation, inability to breast-feed, recurrence of the inversion and the potential need for further surgery.  My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well.  Be careful about utilizing cup size references when it comes to communication.  In my practice, the use of computer imaging and goal photographs is much more helpful. Working together you will come up with a good plan to achieve your goals.  
Best wishes.

Gregory Park, MD - Account Suspended · Answer

Your breast asymmetry can be improved by undergoing a breast lift and small reduction on the larger breast. The nipple inversion can be repaired at the same time. In some cases liposuction of the larger breast can achieve volume symmetry. But, the nipple positions may still be asymmetric. Thanks for your question. Best wishes.

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