Low nipples and empty lower pole. Can this be fixed? (Photos)

Since your nipples are lower positioned and there is some laxity of the lower pole, it is very likely that moderate lift and skin tightening with a peri-areolar breast lift should be considered. Scar is placed around areola and has a tendency to be wider if peri-areolar permanent suture is not applied; be sure to discuss this issue with your surgeon ahead of time. Lowering the implants and placing larger implants may also be an option. Good luck.

Yes, low nipples and an empty lower pole of the breasts can often be significantly improved or corrected through surgical procedures. The best approach will depend on the degree of ptosis (sagging), the amount of breast tissue, and your desired outcome. Here are the main surgical options:

1. Breast Lift (Mastopexy):

This procedure is specifically designed to address sagging and low nipple position.  
The surgeon removes excess skin, reshapes the breast tissue, and lifts the nipples and areolas to a higher, more youthful position on the chest.  
To address the empty lower pole: During a mastopexy, the surgeon can often redistribute the existing breast tissue to create more fullness in the lower pole. Techniques involving internal sutures and reshaping can help achieve a rounder and more projected lower breast.
Nipple Repositioning: The nipples are a key focus of a breast lift, and they are consistently moved to a higher and more central position on the breast mound.  
Scarring: Breast lift procedures do result in scars, but the pattern and extent of scarring depend on the degree of lift required. Common incision patterns include:
Circumareolar (Donut or Round Block): For minimal sagging.
Vertical (Lollipop): For moderate sagging.  
Anchor (Inverted-T): For significant sagging, allows for the most tissue removal and reshaping.
 
2. Breast Augmentation with Mastopexy (Lift with Implants):

This combined procedure is ideal for women who have both sagging and a lack of breast volume, particularly in the upper pole, but also helps to fill out the lower pole indirectly by providing overall volume.
Implants: Placing breast implants can add volume to the entire breast, including the lower pole, which can help to create a fuller and more rounded shape.
Lift Component: The mastopexy portion addresses the low nipple position and excess skin, ensuring the augmented breasts have a lifted and youthful appearance.
Nipple Position: The nipples are repositioned during the lift portion of the surgery to complement the new breast shape and volume.  
3. Breast Augmentation Alone (in select cases):

If the nipple descent is mild and the primary issue is an empty lower pole due to volume loss, breast augmentation alone might, in some cases, provide enough lift to improve the nipple position slightly by filling out the breast envelope.
However, if there is significant skin laxity, augmentation alone will likely not adequately address the low nipple position and may even exacerbate sagging over time.  
Key Considerations:

Degree of Ptosis: The amount of sagging will determine the most appropriate surgical technique and the extent of nipple repositioning needed.  
Amount of Existing Tissue: The surgeon will assess your current breast tissue to determine if redistribution during a lift is sufficient for lower pole fullness or if implants would be beneficial.
Desired Outcome: Discuss your goals with your surgeon regarding both nipple position and overall breast shape and fullness.
Surgeon's Expertise: Choosing a board-certified plastic surgeon with experience in breast lift and augmentation procedures is crucial for achieving the best possible results. They can assess your individual anatomy and recommend the most suitable surgical plan.
Non-Surgical Options:

It's important to understand that non-surgical treatments have limited effectiveness in significantly correcting low nipples and an empty lower pole. While some non-invasive skin tightening treatments (like radiofrequency or ultrasound) might offer very mild improvements in skin laxity, they won't reposition the nipples or add significant volume to the lower pole.

The simplest option to correct your low nipple position would be to do a small nipple/areola elevation to position the nipple over the mid portion of your implant. This would not address your concerns of superior pole fullness, nor inferior pole emptiness, but would give your breast a more balanced appearance and would not involve entering the capsule around your implant. A more involved approach would be to release the capsule which is holding your implant in its elevated position and allow your implants to be repositioned lower on your chest so your nipple is at the midpoint of the implant. This has the benefit of not adding any additional incisions on the front portion of your breast. This approach would decrease the fullness in the upper pole of your breasts and add additional fullness in the lower pole of your breasts. Discuss in detail with your plastic surgeon.