Nipple pointing outward and other breast hangs lower. What happened? (Photo)

Question

5 years ago I had a breast augmentation with saline unders and different cc to try and even out - my right was almost a cup size smaller than the left. After I dropped and fluffed out everything looked and felt as expected. I was even mostly and the fatty feeling was acceptable. 6 months ago - around the same time I started lifting - I noticed my right nipple starting to point outwards now I also notice my left seems a lot more natural and squishy than the right. help!

Farah Naz Khan, MD · Answer

Best to see a board certified plastic surgeon who can properly examine you and determine if you are suffering from a slow deflation or implant malposition that may have worsened after your started lifting. Remember that breast revision surgery is designed to assist with these problems. Good luck!

Nelson Castillo, MD · Answer

Thank you for your questions and photographs, and I can see your areas of concern.  It appears that your breasts may be suffering from implant malposition.  Most noticeable on the picture of you laying down, it seems as if your right implant is falling off to the side more than it should. This has likely resulted from stretching of the implant pocket.  This stretching is also causing the implant to sit lower than your left implant when you stand up.  As far as your left breast goes, it is not clear what may be causing the nipple to point outward, and an in-person examination would be needed to diagnose the possible cause, such as a capsular contracture.  Hope this helps.

Bahair Ghazi, MD · Answer

First of all you do have a noticeable issue...and it is normal. Most women 5 years or so out from an augmentation will develop some ptosis which is sagging of the breast. This combined with weight loss or strength training can exacerbate the natural asymmetry that all women have with regards to their breasts. The good news is that you can undergo an implant exchange and mastopexy which is a lift to better locate your nipples. I have found that athletic patient like yourself do amazing with a switch to a shaped gel implant under a lift...it's a durable operation that will last. All the best

Steven Wallach, MD · Answer

You have what looks like normal breast asymmetry. This can be tweaked a bit perhaps but the two will never be exactly the same.

Tania Medina de Garcia, MD · Answer

Hello Dear, thanks for your question... It seems that you have implant malposition or implants displacement, you should get a consultation with your doctor to see if you will net another intervention to fix the issue, do not worry that can be corrected.

Mark T. Boschert, MD · Answer

There are couple things that could be causing this, but from the picture it looks to me like a deflation.  It could also be a capsule contracture.  An exam would be needed to determine the difference.  Either one can be treated.Good Luck!

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Based on your description and photographs, it sounds like it may be a good time for you to follow up with your plastic surgeon.   Differential diagnosis: deflation, encapsulation (one breast is firmer than the other), breast implant displacement  (especially evident on the supine view). accurate diagnosis will be important when it comes to determining the best plan to improve your outcome. The attached link, dedicated to revision breast surgery concerns, may help you learn more. Best wishes.

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