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

Question

I had a breast aug in tSeptember of 2024, 235cc left breast, 255cc in right breast (Sientra gummy bear). I am so unhappy with the results. My nippples are so low with the lower pole feeling empty and the upper pole is really firm and full. I wanted something very natural. Can this be fixed? Including pics of pre-op, 10 weeks post op and current.

Zoran Potparic, MD · Answer

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.

Chet Mays, MD · Answer

Hi, Thank you for your injury. We would love to sit down and talk with you about your concerns.  Schedule a appointment with a Board Certified Plastic Surgeon to help you reach your goals.

Jeffrey M. Darrow, MD · Answer

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.

Gregory Lakin, MD · Answer

Thank you for your question. Low nipples and an empty lower pole can often be addressed with revision surgery.  The issue may be related to implant placement or a tight lower pole that prevented proper implant descent. A breast lift (mastopexy) may be needed to reposition your nipples to the center of the breast mound. Lowering the implant pocket or releasing the lower pole may help fill the bottom portion of the breast for a more natural shape. A consultation with a board-certified surgeon experienced in revision breast surgery is important.

Daniel Barrett, MD · Answer

Dear Gregarious71494,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

Your nipples were located at or even slightly below your breast fold before surgery, so the implants are making that issue more obvious. A lift would be recommended.

Miguel Mota, MD · Answer

Yes!! Your areolas are low. But the good news is your implants are not that thigh. I can see from your pre-op photos that you needed a breast lift with implants to begin with. This means that lowering the implants will not correct areola positioning….. so the is no need for pocket revision. I recommend a donut lift. This alone should be enough to lift the areola and tighten the skin on the lower pole.

Best of luck,
Dr. Miguel Mota

Best of luck,
Dr. Miguel Mota

Ira H. Rex III, MD · Answer

From your photographs, it seems you may be a good candidate for a breast lift.  This would move your nipples onto the center of the breast mound and give the breast a generally better shape.  Something to think about.  Maybe consider checking with your plastic surgeon about options.

Gary M. Horndeski, MD · Answer

In your pre-operative photograph, you can see your nipple-areola complex was low on the chest wall. Unfortunately, your implants are high and the breast tissue is low. You will need an eccentric donut mastopexy to pull the nipple-areola complex higher and possibly release of the inferior pole of your breast to lower the implant position.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ram Kalus, MD, FACS · Answer

Sorry to hear about your disappointment. An examination in person would be required to properly evaluate you and make specific recommendations. That said, based on your photos and description your implant placement is too high, relative to your breasts and nipples. This can potentially be corrected with a capsulotomy and lowering of your implants, or possibly a mastopexy.

If you still have confidence in your plastic surgeon, discuss your concerns either him or her. If you feel another opinion is warranted, please consult with an experienced board certified plastic surgeon whose results align with your own aesthetics. Best of luck to you.

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

Answers (19)

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