What Causes Nipples to Be Close Together After Breast Augmentation? (photo)

Question

I'm wondering what causes the nipples to be the cause of nipples being close together and how to avoid that. The first photo is of the patient before surgery and the second is afterwards.

Steven Wallach, MD · Answer

It looks like from the second photo that the implants may be displaced too laterally, but it is hard to tell with her pushing on her chest.

Kevin Tehrani, MD, FACS · Answer

Positioning of th implants in the pocket below the nipples does change the relationship of the nipple areolar complex and the breast. In the patient on the right the implants are moved to the outside making the nipples look inwards. This can be corrected by moving the implants more inwards and upwards.

Darryl J. Blinski, MD · Answer

Please post more photos because I too agree this might not be the same patient. The post operative one view shows a lateral over dissection of the pocket causing lateral displacement. This gives a visual effect of inward pointing N/As.

Richard J. Brown, MD · Answer

The position of the nipple areola complex on the breast mound pre operatively is usually a good indication of where they will be after augmentation. If they are uneven before surgery then they will be even more exaggerated after surgery. In situations where nipples are really uneven your surgeon may recommend to move one up to match the other. When the pocket is created for the implant and it is too wide such that the implants sit to the sides then the nipples may appear to be pointing inward. Likewise if the pockets are opened too much in the midline and not enough over the outer part of the breast then the implants will sit too much towards the middle and the nipples will appear to point outward. It is important to make an even pocket that allows the implant to sit right behind the existing nipple areolar complex so that they stay centered.

Hilton Becker, MD · Answer

The  nipples  are close together because the implants are displaced too laterally and too low.this may be as a result of an excessively large pocket created during surgery or subsequent migration of the implant

	In these cases I often use an adjustable breast implant combined with internal mesh support

	The mesh holds the implant in position .The implant is then slowly filled after surgery under controlled conditions  to assure that the implant remains in the desired position

Evan Sorokin, MD · Answer

As Dr. Pousti noted the position of the nipple is going to be in part based on the position of where the implant is placed in a pocket.  This lady has a horrible result (and she may or may not be the same in the pre or post op photos) and I would suggest finding a plastic surgeon who performs large numbers of breast surgeries with proven results.  Check out his/her credentials, check out his/her website, check out online reviews, and then meet with the surgeon and see if you trust him/her to get you a result you desire. 

	Good luck!

Tom J. Pousti, MD · Answer

Thank you for the question.

	During breast augmentation surgery, a breast implant “pocket” is dissected. Care must be taken during the dissection to make sure that the breast implant sits on the patient's chest wall such that the nipple/areola complexes are centered on the breast mounds.

	If the breast implant  sits relatively to the side (laterally), the nipple/areola complexes may appear to be pointing inward and or appear to be too close to one another relative to the position of the breasts.

	Conversely, if the breast implant pockets are too close to the midline of the chest, the nipple/areola complexes may appear to point outward.

	 I hope this helps.

Jourdan Gottlieb, MD · Answer

The first photo shows a patient before surgery. The second photo shows a patient after surgery. I am quite confident there these are not photos of the same patient however.There is no way that her areola that are so far apart pre-op could become so close together post-op without incisions around them. Several moles present on the left side picture are not on the right-side photo. 

	I am quite certain that a pre-op photo of the augmented patient would show that her nipples and areolae were close together before surgery.

Robert M. Grenley, MD (retired) · Answer

These photos are not of the same woman. Breast augmentation does not cause nipples to move closer together. The mole in the center of the chest of the woman in the first photo is not present in the second photo. Nipples do not magically shift around. Implants placed too high might make nipples appear down-pointing on the new breast mound, and implants placed too low or "dropping out" might make the nipples look too high. But I have never seen nipples move closer together or farther apart.

What Causes Nipples to Be Close Together After Breast Augmentation? (photo)

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