Can my nipples/areolas be improved during a breast lift?

Question

Hello! I’m about to turn 19 in a few months and I’ve been interested in getting a breast lift for a few years now. My breasts are very saggy (and they always have been), but my other issue is with my nipples. My areolas are very large and my nipples are very small and flat. Sometimes , if I’m cold for example , my areolas will shrink, rinkle and turn brown, and my nipples will fully retract , almost as if they were inverted. I tried fixing this issue with other methods and tools, but the effects are never long lasting. This has put a huge huge toll on my self esteem and confidence, so I was wondering if a breast lift would also help with fixing my areolas/nipples. Thanks for reading! :)

Warren Schutte, MD · Answer

Hello, a breast lift is great for achieving a higher/tighter breast with improved nipple areolar positioning and areolar reduction. As far as the areolar pigment, this will stay the same for the most part.Nipple projection will not change due to surgery. A deep based areolar piercing can help correct nipple inversion and in more severe cases, surgery can be performed. A consultation with a board-certified plastic surgeon will help answer your remaining questions about breast lift/mastopexy.

Semih Yildiz, MD, FEPOBRAS · Answer

In my experience, a breast lift can often improve nipple and areola position while also reducing large areolas. The areola is usually resized during the lift pattern, and the nipple-areola complex is moved to a higher, more balanced location. That can help if sagging and stretched areolas are the main concerns.
Flat or retracting nipples are a separate issue. Some apparent inversion can improve when the breast shape is lifted, but true nipple inversion may need a specific release procedure, which can affect sensation or future breastfeeding. At your age, I would first make sure breast development and weight are stable, then have an in-person exam to discuss lift scars, areola size goals, and whether nipple correction should be done at the same time.

Robert M. Lowen, MD · Answer

Dear Modest,  Yes, this will probably help, because the lift will remove the extra skin that gets slack and the nipple will probably not collapse in.  Retraction will occur, as this is natural.  You can experiment. Just  put some outward tension on your areola and encounter some cold, like perhaps standing in front the open freezer door.  To the extent the problem goes away or is less, you will have your answer.  Just don't pull so hard that it is tighter than it should be after surgery,  not too much or too little.
  Also, it sounds like you would like a lift because of the sagging.  But  I would not advise having an areola reduction for a big areola without a lift to take out skin.  Otherwise going from a big to a much smaller areola with a purse-sstring suture causes too much puckering and flattening.

Daniel Barrett, MD · Answer

Dear Modest686060,

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

Kadir Berat Oyur, MD · Answer

It is completely understandable that this has affected your confidence, especially at such a transformative age, but I want to reassure you that what you are describing is a very common reason patients seek a mastopexy (breast lift). When we perform a lift, we don't just shift the breast tissue higher; we almost always include an areolar reduction to resize and reshape the area, which addresses the concerns you have with their size. Regarding your nipples, the "retraction" you notice when cold suggests you may have a degree of nipple inversion or flat nipples, which can often be surgically corrected during the same procedure by releasing the tight ducts or fibers pulling them inward. By combining these techniques, we can create a much more youthful, uplifted contour while ensuring the nipple-areola complex looks proportionate and projects more consistently, providing the long-lasting result that external tools simply cannot achieve.

Jeffrey M. Darrow, MD · Answer

A breast lift will reposition your breasts to a more youthful position and reduce the size of your areola.  A breast lift by itself will not treat your nipples, however, a correction of your flat or inverted nipples can be done at the same time with a small incision in the nipple, which allows the breast ducts, which are shortened in flat and inverted nipples, to be divided and the nipple to be pulled out to a new position.  This affords better nipple projection, but may cause issues with breast-feeding in the future. You should have a detailed discussion with your plastic surgeon regarding this. Best wishes.

Gary M. Horndeski, MD · Answer

The breast lift technique I recommend is the Bellesoma. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. The areolas can be reduced to the size you desire.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Can my nipples/areolas be improved during a breast lift?

Answers (7)

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