Large breasts with low nipples (facing ground). What could I do to take care of this? (photo)

Hello and thank you for your question. Based on your photograph, you are a
great candidate for a breast reduction.  This can be designed to result in an
improved shape and contour of your breasts while minimizing scar
appearance.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and evaluate their results.  The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Dear lealiblack,

Determining whether you need simply a breast implant versus a breast lift or both can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position.

Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift.

These two surgeries can be done at the same time and this may be optimal as the risks can be minimized. 

My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift).

Most importantly, it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, it is actually breast tissue that is being brought together to support the breast and hence improves longevity.

On the other hand, many women have overdevelopment of breast tissue and require reductions. Some of the questions you need to ask yourself are if you are willing to have scars from the surgery, take the risk of losing nipple sensation and other complications in addition to possible problems breast feeding if you plan to have children in the future.

It is best that you visit a board certified plastic surgeon to discuss your options further. Only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery