Is It Just by Chance Your Nipple/areolas Point Up After a Reduction or Can You Specifically Say You Do NOT Want Them To? (photo)

You are an excellent candidate for a new technique called The Ultimate Breast Lift.  This is a custom design technique that allows the patient to pick the desired size, shape and position of the breast and areola.  The patient’s measurements and desired outcome are used to create the new breasts.  This technique avoids the ugly vertical scars of the boat anchor shaped incisions while maintaining nipple sensation and the ability to breast feed.  The breasts are reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Asymmetry can be corrected as well. 

 

Best Wishes,

 

Gary Horndeski, M.D.

you appear to be a good candidate for a standard breast reduction which has a 'breast lift' built in - you and your surgeon should be able to discuss how you would like your breasts to appear post op.

I have never thought of the problem being nipples pointing up after reductions.  But, after reviewing some of the photos that you may be looking at I think what you are seeing is an effect of the breast tissue being too low.  For Breast Reductions in San Antonio I use the SPAIR technique which is a short scar technique that leaves the nipples at the most prominent portion of the breast.  In this location, they point straight ahead.  In many of the "standard" inferior pedicle technique results, you will notice that the most prominent portion of the breast drops quickly and thus the breast tissue hangs low and that makes the nipples rotate to point up.

I would advise you visit several Board Certified Plastic Surgeons before choosing the one you are most comfortable with and reviewing your concerns with him/her.

 

can be customized for your desires.  If you don't like the standard look from routine reductions, let your surgeon know and you will have to decide on just how much to lower them (1-2 cm) and in addition, if you desire the somewhat droopy look, your lower pole will have to be lengthened slightly.  Make sure your surgeon understands your goals and he/she should be able to alter the procedure to avoid what you don't want... BUT still cannot guarantee what kind of result you will ultimately have.  And if insurance is covering this, your surgeon may have to remove minimum weights for this to be covered, which could change the outcome.

Requesting the position of your N/A complexes in your case might be hard to provide since you have a significant asymmetry. Best to ONLY discuss in person not via the internet. 

A certain amount of the shape will be determined by your anatomy. Certainly the breasts can be reduced and the asymmetry can be improved and the nipples raised.

Yup, some plastic surgeons tend to put the nipples a little high, some a little low. Specifically tell your plastic surgeon you would like them to on the lower side, as the location is completely controllable. It helps if you look at the before and after from that surgeon, I would really emphasize your desire to have them lower VERY strongly if you find that the before/afters are all high for that surgeon! Most helpful for me is to bring in photos of breasts you think look great/natural as a guide. Finally, a good rule of thumb is to place the nipple location at the inframammary crease when marking pre-operatively. Seems low, you may say, but the nipple springs up when the extra rate is reduced.

Congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations performed.

 Choosing your plastic surgeon carefully and communicating your goals carefully with your plastic surgeon will be 2 of the keys to achieving your goals.  During your consultations and during the marking session, make sure you communicate any specific preferences  and/or concerns you may have.

 Best wishes.