Can Breast Augmentation Cause the Nipples to Flatten?

I had 325 cc implants 3 weeks ago and my nipples, particularly on one side, are much flatter than they were pre-surgery. Is this permanent or will they relax and return to their original 'erectness'?

Doctor Answers 9

Areolae stretched out following breast enlargement

Part of the reason that your nipples are flatter are because they are stretched out with the placement of the breast implants. The incisions around your areolae can also affect this. Finally, it appears that you might have had a peri-areolar lift which could further stretch the skin out.

Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Nipple erectness after breast augmentation

Early on the breast implant will stress the skin envelope of the breast and the nipple will stretch and lack the erectness before implants. Your implants appear slightly high and hopefully will settle into to a point of projection at the level of the nipple. As the skin relaxes the nipple will again be softer the have the necessary give to become erect with cold or stimulation.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Nipple/areola flat after Augmentation?

Thank you for the question.

If you had a circumareolar  breast lift in combination with your breast augmentation  then some flattening of the nipple areola complex and breast profile is commonly  seen.  This flattening of the breast profile is a downside of the incision around the areola which serves to “pursestring"  the tissues.

Unfortunately, only time will tell if it will be an improvement in the situation.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Answer to breast augmentation/nipple question

Gail-  It appears that your augmentation was done via a peri-areolar approach or with a peri-areolar type mastopexy.  This can cause temporary flattening of the nipple, as well as the breast.  These changes will improve with time.  There is still a fair amount of tissue relaxation and stretching that will occur.  Best wishes.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.7 out of 5 stars 28 reviews

Flattening of the Nipples With Breast Augmentation

It appears from your photo that you had a circumareolar lift in which an incision is made around the entire nipple-areola.  This type of lift does cause some flattenting of the nipple-areolar complex, particularly early in the healing process.  As the tissue stretches over time, your nipple-areolar complex should spring back to some degree.  The presence of the implant will further help your nipple-areolar complex to stretch by placing pressure on the skin.  Best Wishes!!!

Louis DeLuca, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 54 reviews

Nipples are temporarily stretched after augmentation


Yes, as the breast skin is stretched so are the areolas and nipples.  When this happens you will notice some flattening of the nipple area.  You are relatively early after your surgery and as your breast skin accomodates you will see an improvement in this area.

All the best,

Dr Repta 

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 165 reviews

Nipple projection after breast augmentation

another variable that has to be considered in your case is that the ability of the nipple to have projection is due to the effects of the nerves on the muscles of the nipple causing projection. If the nerves are not functioning normally due to stretching or pressure, they can limit the degree of projection of the nipple. As the nerves regain their normal function in time, the nipples should return to their normal degree of prominence.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

It can if you had a nipple based incision.

Hello Gail,

It appears that your surgeon used a periareolar incision to place the breast implants and give you a minor breast lift.  When you tighten around the nipple, it can flatten.  However, the tissues are tight and with time will relax.  This may cause them to unflatten a bit.  Give it time to see what happens.

Good luck,

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 56 reviews

Nipple flattening after augmentation

The nipples may flatten out after augmentation, especially if a periareolar incision was used.  You are stil early in the post op period and things should improve as the swelling decreases and the implant drops a little more.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 47 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.