Why Match the Inframammary Fold Height in Mastopexy? (photo)

I'm looking into getting a breast lift without implants. I am a modest A cup but very happy being flat chested, just not with the sag. My understanding is that the nipple 'should be' at level with the inframammary fold. For me, despite very loose sagging breasts, this measurement means I'd only get a cm height difference with a lift, which makes it somewhat pointless. Can lifts go higher? Because of my small size and lack of projection, would 'upward facing nipples' still actually be an issue?

Doctor Answers 8

Nipple Areola Complex Should Be at Center of Breast Mound

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   The nipple areolar complex should be at the center of the breast mound.  A circumareolar lift can be performed to lift the areola and reduce some of the skin excess.  However, the circumareolar lift always flattens the breast to some extent.

Why Match the Inframammary Fold Height in Mastopexy

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It is not the nipple but the bottom of the areola that should be even with or above the breast fold. This is a guideline, one of several used in determining nipple/areolar position. Others include placing the nipple/areola on the center and most projecting part of the breast, and a measurement of 20 to 22 cm a from the top of the breast bone. 

You would clearly need more than just one cm of elevation to make a meaningful difference in appearance. 

Thanks and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Nipple height

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The nipple level should actually be above the fold, not at the same level. Your nipple should be a distance of about 20 centimeters from the stern all notch of the neck.  In your case, I estimate the nipples will be elevated about 2 inches.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

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Small lift in a small breast

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You can have a nipple lifted to a higher position than the inframammary fold - that's just a guideline used by plastic surgeons. Mostly we use that guideline when we mark breast reductions, because the skin makes the nipple spring up even more when the weight is removed. For you, you can do a skin lift only with fat grafting (outer thigh), or you can do a small breast lift where the breast itself must be lifted, not just the skin, or the droopiness will come back.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

Nipple height depends on placement of the implant

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"Bottoming out" of the implant after a breast lift with implants is a real concern and often causes surgeons to place the nipple and areola complex lower to account for this possibility.  We have been a procedure for over five years (which means we have patients five years out from surgery) that we feel limits bottoming out, thus allowing us to place the nipple higher.  Please check out our website for before and after pictures.  Hopefully this will be helpful.

Nipple height with mastopexy.

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You appear to be a very fit, athletic person. If you are happy with your breast size and not position, a lift would work nicely. You will still have fairly small breast size, but shape and position will be improved. Raising the nipple height to at least the inframammary fold is good and may be a little higher for better results in your case.  


Be open and honest with your goals with your plastic surgeon so you both understand each other. It is always easier to correct lower positioned nipples than those that are too high.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breast lift

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The position of the nipple is really dependent on the patient's anatomy.  In general, ideal nipple height is slightly above the fold.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast lifting and Position of Nipple/Areola Complexes?

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Yes,  it is possible to raise the nipple/areola complexes too much during breast lifting surgery causing the nipple/areola complexes to be “upward gazing” or “stargazing”. Ideally, the position of the nipple/areola complexes should be HIGHER than the inframammary folds.  Please also see my response to  the other question you posted.

 I hope this helps.

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.