Is it possible to fix high uneven areola/nipple when skin is already tight from breast lift?

Question

Is it possible to fix high uneven areola/nipple when skin is already tight from breastlift? do you need excess skin to fix it? what if theres not excess skin

Leila Kasrai, MD, FRCSC · Answer

It is possible to improve symmetry even if the breast skin is tight already. However, an in-person assessment would be needed to determine if it is possible for you.

Daniel Barrett, MD · Answer

Dear jasminoxo,

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

Emre Guvercin, MD, FEBOPRAS · Answer

Yes &mdash; it is absolutely possible, and you do not need excess skin to fix this.Why excess skin is not requiredUneven or high areola position after a lift is not a skin problem &mdash; it’s a structural problem:The breast mound underneath is unevenTissue support is asymmetricThe nipple–areola complex is sitting correctly relative to the skin, but incorrectly relative to the breast shapeTrying to “wait for more skin” or stretch skin is not necessary and not helpful.How this is corrected when skin is tightThe correct solution is a Push-Up Lift (supportive revision mastopexy).With a Push-Up Lift, the surgeon:Repositions and reshapes the breast tissue internallyAdjusts nipple height by moving the breast mound, not pulling skinCorrects asymmetry without tightening the areola furtherUses low-tension closure, which protects blood supply and sensationBecause the correction comes from inside, tight skin is not a limitation.What does not workCrescent liftsPeriareolar tightening aloneSkin-only revisionsThese approaches usually worsen distortion and increase the risk of scar problems or further asymmetry.

Jeffrey M. Darrow, MD · Answer

The normal position of the nipple/areolar complex is equal to or 2-4 cm above the level of the inframammary fold and center at the midpoint of the breast, at the most projecting portion.   If the nipple/areolar complex is placed too high during a breast lift, there are 2 options:   to move the complex lower, an incision could be make around it and when the complex is moved lower, an opening is created that needs to be closed and this is the area that is usually above the bra line and hence will be very visible.  The alternative option is to raise the inframammary fold so it is in correct position in regards to the nipple/areolar complex.  It is difficult to create a higher, natural, permanent inframammary fold.  Best wishes.

Matthew C. Camp, MD · Answer

It depends on if you have an implant or not. In the case of people who have a breast lift with implant, you can correct the malposition by downsizing the implant, and removing skin from the lower pole, shortening the breast. This effectively lowers the areola without any scar on the upper pole of the breast. Seek the care of a board certified plastic surgeon to learn your full range of options.

Miguel Mota, MD · Answer

Yes! This is usually very easy. In most cases, removing skin from the lower pole of the breasts should bring the areola down to level.

Best of luck, 
Dr. Miguel Mota

Eric Swanson, MD · Answer

Unfortunately an overly elevated nipple position is common after a traditional breast lift using an anchor scar (inverted-T, Wise pattern). This is because of the geometry. The nipple is transposed up because the skin flaps are pulled down. The vertical breast lift is much superior because the tissue is removed from the lower pole and the two sides are brought together, trading width for projection, which is much more desirable than trading projection for width. You will need a skilled surgeon to correct this problem. It is not easy and involves usually using an implant and pulling the nipple and areola down into better alignment.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs.  I would need photographs to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Rajaie Hazboun, MD, MBA · Answer

Thank you Jasmin for posting your question here!I will start by stating that my answer is based on the limited information provided, for a more bespoke plan please consult with your plastic surgeon.It is hard to assess the issue without examining the patient or at least looking at pictures, that being said if the issue is not very extensive (if you don't need to move the nipple , and it's just an issue of different sized areolas) this can probably be done even if there is not much skin laxity , that being said if the skin is very tight then you risk tension on the wound , wound breakdown and bad scarring not to mention areolar spreading due to the tension ( there are some tricks that you can utilize to decrease the chances of that happening but there are no guarantees and there is always a chance of hat happening) .if the issue needs extensive work ( you need to change both the position of the nipple drastically and the size of the areola and the skin envelope is very tight then if you are not willing to go smaller either through some sort of breast reduction or implant removal +/_ implant exchange to a smaller size if you have one then I would recommend against it .That being said the answer will depend on your surgeon examining you and assessing what needs to be done and if it is feasible.

Connie Hiers, MD, FACS · Answer

You did not post photos, so I cannot be specific. However, many times the nipples can be lowered by removing excess tissue below the breasts with an inferior incision. In many women, the nipples are in good position, but the lower breast is sagging.

Is it possible to fix high uneven areola/nipple when skin is already tight from breast lift?

Answers (13)

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