Should you have to cut off nipples then graph them back on in a breast explant lift surgery? What's the correct way to do this?

Question

I went in for a breast explant and breast lift. My surgeon decided to cut my nipples off and graft them back on. Her reasoning for this was my nipples were too low and she could not raise them. I have attached before and after pictures. Do my nipples look too low to move up? The stitching job is horrific as well. It doesn't seem like my nipples even had a chance of survial with no blood flow? However, they did not survive. What is the correct way this should have been done?

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I am sorry to see your outcome.  In most cases this combination of procedures can be safely performed, but when questions of tissue viability exist, it is better to stage the procedure with implant/capsule removal followed by a breast lift 6+ months later.  Hope this helps and that you heal uneventfully from here.

Camille Cash, MD · Answer

No, it is not typically necessary to perform a nipple graft with an explant and lift.  I'm sorry that you have had this unfortunate result.  If the nipple viability is in question the procedures can be staged in order to have less trauma to the breast and thus lower risk.

Christine Rodgers, MD · Answer

Hi Jassie,No, it is usually not necessary to cut off the nipples after an explant and lift. So sorry for your result. I would suggest that you go back to your PS ( I hope that it was a board certified PS) and discuss what can be done at this point.Best Wishes,Dr, Christine Rodgers

Tom J. Pousti, MD · Answer

I am sorry to hear about the complications you have experienced.   It is hard to give you more specific thoughts and/or recommendations based on the limited information.  Having said that, based on your photographs, your nipple/areola complexes have experienced a problem with perfusion,  requiring their removal.  It is likely that nipple/areola complex reconstruction will be necessary in the future.  Based on your photographs and description of concerns, further revision of the mastopexy surgery will also be necessary to improve overall breast contour. Best wishes.

Should you have to cut off nipples then graph them back on in a breast explant lift surgery? What's the correct way to do this?

Answers (4)