I Have an Inverted Nipple, Large Areolas, and Sagging Breasts from Pregnancy, What are My Options? (photo)

I went from a 36C to a 40F while pregnant, now I am back to a 36C. I now have lifeless, sagging, breasts with extra skin and large areolas with a nipple that has decided to invert on its own (left nipple). I would like perkier fuller and more attractive breasts that are closer together with a smaller areola and a normal nipple. How can we accomplish this? What is the down time? How soon would I be able to fly after surgery? How long before I would be able to hold/carry my toddler?

Doctor Answers 14

Improvement in breast shape via a breastlift.

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Given the goals that you stated, a breastlift or mastopexy is your best option. Whether or not to add implants depends upon how you feel when your breasts are properly fitted in a bra. If you like the volume in a well-fitted bra, implants are not necessary. A mastopexy will reduce the areolar size, improve the position of the nipples, improve breast projection (perkiness), and remove excessive skin. The recovery is fairly rapid (1-2 weeks), you can fly after a few days, and you can lift your toddler in 2-3 weeks. Also, if you wished to have an augmentation at a later date, it becomes a much more straightforward procedure when staged after a mastopexy.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Surgical Options For The Post-pregnancy Breast

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It's not unusual for women to note significant changes in their breasts following pregnancy. Your pictures suggest several areas of concern. Not only do you have breast hypoplasia, but you also have bilateral breast sag. In addition, your left breast is larger and has more sag than your right breast. It's also important to note that you have enlarged areolas and an inverted left nipple.

Correction of these problems will require breast augmentation with larger fill volumes on the right side. Breast lift surgery will also be required. This procedure will also address your enlarged areolas. A secondary procedure at a later date can be easily performed to correct your inverted nipple.

It's important to consult a board certified plastic surgeon who has experience with these procedures. Several issues require resolution before proceeding with surgery. These include the size and style of breast implants. The type of lift and the position of the implant relative to the chest muscles. Once you have a comfort level with these issues, it's reasonable to proceed with surgical intervention.

Patients are able to resume most of their normal activities one week after surgery. Heavy lifting should be avoided for at least 6 weeks following surgery. Patients should avoid air travel in the immediate post-operative period unless covered with Lovenox whenever possible.

Breast augmentation, inverted nipple correction, areola reduction

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This is what I do to maximize lift with a breast implant alone:

- use silicone cohesive gel implants. The more cohesive the better. I am not sure if these are available yet in the US, but the Allergan Inspira Truform 2 implants are ideal

- use high profile implants. The more projection you have, the more lift you will get

- have the implants placed in the submammary pocket (under the breast itself). You should have a pinch thickness at the top of your breast of at least 2 cm

However, a lift may be better able to achieve your expectations. Areola reduction can also be performed .

Achieving perky, attractive Breasts after pregnancy

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hi there-

It is first important to be sure you will have no further children, as another pregnancy will probably adversely affect any surgical outcome achieved.

Secondly, please be aware that nipple inversion, when new, can be a sign of a problem that you should notify your family doctor and/or gynecologist about.

Assuming that you are healthy and there are no concerns about your breast health, your options are to have your breasts lifted, or to have them lifted in conjunction with placement of an implant.

From your description of your goals, I think you would probably be best off with lift/implant, but the best advice I could give you is to spend your time and energy researching and locating a GREAT SURGEON, and THEN worry about the what and the why.

How to do this? Please read this:

A cure for sagging breasts

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I would recommend a breast lift together with modest size breast implants. I would emphasize the lift over the size. These two procedures work in sort of opposite directions. The larger you want your breast, the less tight it can be made. Because you want your areolas to be smaller, and I agree with you on that, more skin will need to be removed in order for them to look good. With more skin being removed there is less room for the implant. Basically I would recommend going for the "higher, tighter, perkier breast" rather than the "larger fuller breast". I still think that an implant of about 250-300cc would work which at the end of the day would increase your cup size by about 1 size

Breast Contouring After Pregnancy

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You would be a good candidate for a breast lift (which would also reduce the areolar width) and a breast implant, if you desire to be fuller with more upper breast definition.  The best option for you  would be discussed at the initial consultation when you review with your surgeon your goals for surgery.  Nipple inversion might improve after breast augmentation. . .however after a physical exam, it could be determined if correction of inverted nipples could also be performed at the time of the initial breast surgery.  You can certainly fly after surgery. . . would recommend waiting two weeks if you live out of town.  However, if you are a flight attendant, I would want you to refrain from working if you are having to do exertional activity for 3-4 weeks following surgery.  It is impossible not to hold/carry your toddler. . . but do so with discretion and try not to do lifting with you upper body strength following surgery for a few weeks.

Breast Lifting and Augmentation

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Thank you for the question and pictures.

I think you are an excellent candidate for breast augmentation/mastopexy surgery. This operation should meet all of your stated goals. The operation will involve “down time” of about 1 week. You should be able to fly after a few days and hold/carrier toddler after 2-3  weeks.

Best wishes.

Sagging breast options

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You would be a candidate for either a mastopexy with areolar reduction alone or an augment/mastopexy, depending on your personal preference. I would recommend deferring treatment of the nipple inversion until after the mastopexy because it may improve as a consequence of that surgery. In terms of flying, I recommend that you wait for at least two weeks after surgery and then refrain from lifting heavy objects. Also, in terms of lifting your small child, this is a great time to teach him or her to climb up!

Sagging Lifeless Breasts

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An augmentation with mastopexy will improve your volume, lift your breast, and reduce the areolar size.  Your left nipple appears to be only partially inverted as it is protruding in one of the pictures.  This is common and will sometimes improve after implant placement.  I would recommend that you see what happens with the nipple inversion after the surgery, then correct it at a second procedure if it is still inverted.

Breast lift

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It appears that you would be a good candidate for an augmentation mastopexy (breast implants and lift).  This procedure includes an areola reduction as part of the lift.  Most of my patients have  this done all at one surgery.  Sometimes placing an implant will correct an inverted nipple.  I would recommend having the augmentation mastopexy done and then if the nipple is still inverted it can be corrected as a simple office procedure at  a later date if needed.

You need to visit with a Board Certified Plastic Surgeon to discuss the technique of lift and the augmentation options.

Gary Hall,MD

Gary Hall, MD (retired)
Kansas City Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.