What causes flat & darker nipples after breast lift on ethnic patients & how can this be prevented?

Stretched out areolas spread the skin pigment out thinning the color. After a breast lift/reduction, the areolas contract concentrating the pigment making them darker (and perhaps flatter). I think the is a natural result of the operation and I doubt avoidable as the areolas are always downsized with the operation. I suppose that one could try to leave as much original areolas as possible to avoid this, but not sure if the overall look would work.

Changes to nipples and areola color are typically due to blood flow changes. This really cannot be prevented. Great scar care in the post operative period will be the most important protocol.

The flatness is tension on the closure. The circumareola, the lollipop and the anchor incisions all have tension on the closure. An alternative to consider is The Bellesoma Method. This technique does not put tension on the areola closure. 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.

Best Wishes,

Gary Horndeski, M.D.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, if interested. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

The color change is due to the skin reacting to the scar. Darker skin usually makes darker scars. Using scar products once the sutures or tapes are removed can be helpful and avoiding sun exposure for 6 months.

Flat and darker nipples after a breast lift, particularly in all patients, can be attributed to several factors:1. Post-surgical healing process: Following a breast lift surgery, especially in patients with more melanin in their skin, there might be increased pigmentation around the areola and nipple area due to the body's natural healing response. This can result in a darker appearance.2. Changes in tissue elasticity: The reshaping and tightening of breast tissues during the lift procedure can sometimes lead to alterations in nipple shape and projection. In some cases, nipples may appear flatter or less prominent post-surgery.3. Scarring: Scar tissue formation around the nipple and areola complex can contribute to changes in nipple appearance. Scarring can sometimes cause the nipple to appear darker or less defined.To prevent or minimize these effects, certain steps can be taken:1. Pre-surgical consultation: Like all patients, should have a thorough discussion with their plastic surgeon about their expectations, potential outcomes, and any specific considerations related to their skin type and healing process.2. Choosing an experienced surgeon: Selecting a board-certified plastic surgeon experienced in performing breast lift procedures, particularly on all patients, can help ensure optimal outcomes and minimize potential complications.3. Careful surgical technique: Employing precise surgical techniques, including careful preservation of blood supply to the nipple and areola complex, can help minimize changes in nipple appearance post-surgery.4. Proper wound care: Following post-operative care instructions provided by the plastic surgeon is crucial for promoting optimal healing and minimizing complications, including changes in nipple appearance. This may include keeping the surgical area clean, avoiding excessive sun exposure, and using recommended scar management techniques.5. Use of skin lightening agents: In some cases, plastic surgeons may recommend the use of skin lightening agents to help minimize post-operative pigmentation changes around the nipple and areola complex. However, the use of these agents should be carefully monitored and discussed with the plastic surgeon to ensure safety and effectiveness.6. Regular follow-up visits: All patients undergoing breast lift surgery should have regular follow-up visits with their plastic surgeon to monitor healing progress, address any concerns, and ensure optimal outcomes.

Hi. You are flat out wrong about race being an issue.

There is no difference between Irish and South African breast results if they start out the same, except perhaps scar quality.

The difference you see is your selection bias and most likely photographic loss of shadowing.

The only Prevention is being sure the initial incision around the nipple is not under too much tension that can lead to some flattening.

Good luck

Having a breast lift by itself, should not change the color of the nipple or areola. Pigmented skin that is put under tension may have a lighter complexion. If the skin is pulled together from the tension of sutures, then pigmented redundant skin can have a darker appearance.
Flattening of the areola is most common from a Benelli type breast lift. Using a better technique minimizes the chance of this.
Best,
Mats Hagstrom, MD