Beckoning Breasts- slightly turned-up nipple: Is there special training required or expertise to achieve this look?

Question

I'm getting my implants removed (DD) and going natural or getting a small implant in (C). I'm obsessed with nipples that slant slightly upwards. I've read there's a term for this: "beckoning breast". I have been scouring doctors before/after pics to find a doctor who has this "style". Is this usually a special request? Can you get this look with a lift (since my nipples will most-likely need to be re-positioned)? Is there special training required or expertise to achieve this look?

Steve Laverson, MD, FACS · Answer

There are good reasons you see some, but not many outcomes with nipples canted upwards. First, this occurs when the bulk of breast glandular tissue is situated slightly below the horizontal breast meridian.  Gravitational settling of implants into expanded lower pole breast skin envelope and stretching of the skin and soft tissue that allows this settling takes time, perhaps a year or more.  Most post-surgical photos are taken only two or three months after, before settling occurs.  When center of implant drops below location of nipple-areola complex on skin, nipple is positioned higher on implant and directs upward.  
Second, “bottoming out” of implants is feared among patients, and is commonly an indication for revision augmentation.  To avoid bottoming out, many surgeons stabilize the implants to avoid settling that would cant the nipple upwards on the breast mound.
Third, a nipple that is slightly low is a straightforward office correction.  A nipple that is too high, that shows over the top of low cut clothing or swimsuit top, represents a very difficult surgical challenge.  Tissue expansion and/or other extreme measures are required to lower the nipple.  Thus, in planning, we err on the side of nipple too low on the skin rather than too high, knowing that implant settling over time may raise the nipple location relative to a descending implant.
There are other reasons as well that the “beckoning” look is not dominant among results, related to patient preference, chest dimension, skin elasticity, and implant design.  Still, careful planning and skillful execution by an experienced artistic surgeon will likely result in the outcome you envision.

Ronald J. Edelson, MD · Answer

Tough to a answer without photos of you and what you mean by beckoning breasts.  You should go on some consults and have an idea of what you don’t like and what you want to achieve.  Then you will be able to weigh your different options.

Gerald Minniti, MD, FACS · Answer

Hello,The nipple position on the breast mound can be affected by implant size, and frequently smaller implants will help give a up turned nipple. However in others, a breast lift will also be necessary. Going to the internet to look at other peoples breasts will not give you the answer you'll need to achieve that same result in you. Go visit a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

Urmen Desai, MD, MPH, FACS · Answer

No, this is an inherent property of someone's nipples/breasts.  Every patient is different.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Daniel Barrett, MD · Answer

Dear dallasgirl32,there is no special training to achieve beckoning breasts. Every board-certified plastic surgeon should be able to achieve it. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Mathew A. Plant, MD, FRCSC · Answer

With a lift nipples can essentially be positioned as high as you want, however putting them too high on the breast mound can have consequences. The most important is that the nipple can show above bras and bathing suits. I'd suggest you book a consultation with a board certified plastic surgeon near you to discuss your options. Best of luck!

Tim Sayed, MD, MBA, FACS · Answer

Our colleague Dr. Laverson gave a great explanation here. In short, how your nipples are situated after breast surgery depends in part on how they were situated before the procedure; if your breast mound tissue is more pendulous/dependent in the lower pole of the breast, you may be setup to develop the upturned nipple you seek but you might also be at risk for bottoming out and stretch of the lower pole. For these reasons, surgeons often try to control for the bottoming out risk by making sure he implants are stabilized into a reasonable position and if a lift is being performed, excess skin may be removed in the lower pole. The complex dynamic between the implants and your native tissue can often change the shape over time, so it may be difficult for you to hang your hat on the notion that you will definitely get this beckoning breast look you are seeking. Exam in the office would help the surgeon ascertain how much overhang of the tissue you have, where your nipples currently sit in relation to your folds and other landmarks, etc. There is no special training or style of surgery that can promise this result. You need a frank assessment in person with one or more surgeons and a review of your options in office.

Curtis Wong, MD · Answer

as a lift involves lifting the lower pole tissue and eventually, gravity will pull this down, canting the nipple upwards and increasing the length of the lower pole... and if you get this at the get go, you will be facing bottoming out down the road so remember, whatever result you get will not last forever.  Revisions will always help improve the breast shape for you so anticipate having them in the future.

Raj S. Ambay, MD · Answer

There is no special expertise required to do a breast lift in a person who is board certified in Plastic Surgery. There are differences in surgeons and their outcomes. Measurements are the key that help guide the surgeon to the appropriate procedure. Then, artistry provides the final touches from an aesthetic standpoint.

Tom J. Pousti, MD · Answer

Thank you for the question. No, there is no special training required to achieve the "beckoning"  or "stargazing" nipple/areola (nipples/areola complexes sitting relatively high on each breast mound) positioning. Careful measurements and appropriate planning of the breast lift will be required. My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well.  The use of goal photographs and/or computer imaging may be very helpful in this regard. Working together you will come up with a good plan to achieve your goals. Best wishes.

Beckoning Breasts- slightly turned-up nipple: Is there special training required or expertise to achieve this look?

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