Nipple repositioning after implant removal - is this possible? (Photos)

Question

I’ve had 3 disappointing revision surgeries with different surgeons. I’m ready to remove the implants and try to make what i have as aesthetically pleasing as possible. Ideally, I’d like to have my nipples point forwards and be closer together, and the little tissue i have repositioned to get rid of the east west look. Pictures of me before and now, and my desired result. Is this possible?

Alan Gonzalez, MD, FACS · Answer

Hello @orion724, thank you for your question.  You could have an explant with total capsulectomy and given that you have good mammary tissue I consider a breast lift to reacomodate the mammary tissue and lift the areolas and nipples. The breast shape is improved by reorganizing the breast parenchyma.  To shed more light, I share a video. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS.    International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Christine Fisher, MD, FACS · Answer

Hi Orion.  Going through 3 revisional surgeries sounds tough.  I'm so sorry.  I see few different challenges in your case.  You naturally have a wide cleavage along with a prominent breastbone (possibly a pectus).  It may be possible to bring your nipple closer together with a explant and lift.  I would also likely recommend fat grafting to a patient such as yourself.  Breast revisional surgeries are technically very challenging.  I highly recommend seeking out a board-certified plastic surgeon such as myself that has extensive experience in tough breast reconstruction as well as revisional breast surgery cases.  Best of luck acheiving your aesthetic goals!

Emre Guvercin, MD, FEBOPRAS · Answer

I’m really sorry you’ve been through multiple disappointing revisions. What you’re describing is understandably exhausting &mdash; but the goals you’re outlining are realistic if the correction is approached correctly.Can nipples be repositioned after implant removal?Yes.After explant, nipples can absolutely be repositioned to:Face more forwardSit closer togetherLook more centered on the breast moundHowever, this cannot be achieved with implant removal alone.Why explant alone won’t fix the “east–west” lookThe east–west appearance comes from:Lateralized breast footprintLoss of central supportTissue that has been pulled outward over time by implants and stretched pocketsRemoving implants without reshaping leaves:Nipples still pointing outwardTissue still dispersed laterallyA flat or wide breast moundSo while explant is an important step, it’s only the first step.What actually corrects nipple direction and spacingThe solution is a Push-Up Lift (supportive mastopexy) performed at the time of explant.A Push-Up Lift allows the surgeon to:Rebuild the breast mound using your own tissueMedialize and centralize breast tissueRe-anchor the breast footprint on the chest wallReposition the nipple–areola complex so it:Faces forwardSits closer to the midlineLooks proportional and intentionalThis is not a skin-only lift &mdash; it’s structural reshaping.Is this still possible after multiple prior surgeries?Yes &mdash; but it requires:An experienced revision/explant surgeonCareful planning of blood supply and scar patternsRealistic goals (improvement, not perfection)Even in patients with limited tissue, meaningful improvement in nipple orientation, spacing, and overall breast shape is very achievable.What to expect realisticallyAfter explant + Push-Up Lift:Breasts will be smaller but better shapedNipples will look more forward-facingThe east–west appearance can be significantly reducedThe result will feel more natural and stable than implants ever did

Chet Mays, MD · Answer

Thank you for your inquiry!  We would love to meet with you to discuss your concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Richard Baxter, MD · Answer

your pre-existing nipple position was quite lateral, and they definitely point more forward with the implants. However, having implants expands the skin envelope and re-distributes the breast tissue over time; this means that a breast lift is almost always necessary. Nipple position could be medialized when that is done. Depending on what your current concerns are and details of your revision procedures, it might make more sense to keep the implants but reposition them higher and do less of a lift to improve nipple position.

Daniel Barrett, MD · Answer

Dear orion724,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Shaher W. Khan, MD · Answer

Hello. Thank you for your question. I have attached a video that discusses your concerns in detail, please view this. The exact outcome depends on factors like skin quality, tissue availability, and how much tissue you have after implant removal. It is essential to work with a board-certified plastic surgeon experienced in complex breast revisions, as these procedures require advanced skills and planning.

Gary M. Horndeski, MD · Answer

Yes, you would benefit from implant removal and repositioning of the nipple-areola complexes. The excess skin around the nipple-areola complexes can be used as a graft to attach and pull up the nipple-areola complex more medial. I need to know if the implants are in front or behind the muscle to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

With your anatomy, your nipples naturally sit far apart. They could be placed more medially with a lift, but you still will have some lateral placement.

Camille Cash, MD · Answer

You can expect some improvement with removing the implants and repositioning the nipple/areola complex.  The best place to begin is a visit to a board certified plastic surgeon near you for a consultation.  You can find a list of surgeons on the ASPS website and review websites, credentials, before/after photos of their work.

Nipple repositioning after implant removal - is this possible? (Photos)

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