DDD breasts and very low nipples. What are my options?

Question

I am an 18 yr old who's always had big breasts throughout my teen yrs. I am thinking of doing a breast reduction but I am worried about the situation with my nipples. They are VERY low, and I've heard of one opt that doesn't take away sensitivity/breast feeding but I've also heard (might be wrong) that if the nipples are too low, a surg would have to remove my whole nipple to place it higher and I would lose sensitivity/breastfeeding opts. Can you let me know if that is/isn't the case with me?

Gary M. Horndeski, MD · Answer

Thank you for your question and for sharing your photos.There are current techniques such as the Ultimate Breast Reduction method that does not require removing the nipple/areola complex as a graft, hence nipple vascularity and sensitivity are preserved. Using the UBR method, the ability to breast feed is also preserved. Upper pole fullness is achieved without implants and the vertical incision is completely unnecessary. You are welcome to visit my gallery to see what can now be achieved with improved breast reduction/lifting technology.Best wishes and kind regards,Gary Horndeski M.D.

Richard H. Tholen, MD, FACS · Answer

Once you have reached your ideal weight and are stable at that healthy point, you would be an excellent candidate for breast reduction surgery utilizing inferior pedicle Wise-pattern (anchor) technique. Though the pedicle would be longer than the mythical "average," this could still leave intact milk ducts and sensation in a percentage of cases. Even a majority.But not all, and no guarantees. Everybody's anatomy is different, and there is no way to absolutely preserve either; all one can do is to choose a technique that offers the highest likelihood for success. Seek consultation with one or more ABPS-certified plastic surgeons with lots of seniority and experience with breast reduction. If possible, please lose weight to ensure the safest operation for you, as complications are higher in patients with BMI over 30. Best wishes! Dr. Tholen

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your post and provided information as well. Extremely large breasts have been linked to a number of physical complaints including back aches, neck pain, and numbness in the fingers in hands. They have also been implicated in migraine headache known to cause shortness of breath, and have prevented women from doing everything from aerobic exercise to picking up their children, to sitting at a desk."Sometimes a woman with very large breasts will know instinctively that the extra weight on her chest is causing the problems but just as often she doesn't recognize the connection and sometimes that can lead to years of unnecessary suffering,"I f you are considering a breast reduction I suggest to make an appointment with a Board Certified Plastic Surgeon for a person evaluation and talk about your concerns and goals. Good luck :)

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

A breast reduction would make your breast smaller and position the nipple higher and on the front of your breast. I would use an anchor shaped scar technique. I do not think your nipples would need to be removed completely so some breast tissue would be preserved behind the nipple. There is the possibility that you would be able to breast feed and retain sensitivity but you would have to accept that there is a good chance that you will not.Check that you take advice from a suitably qualified and experienced surgeon.

Darryl J. Blinski, MD · Answer

Thanks for the great questions and excellent posted photos! Any breast reduction technique whether free N/A grate to pedicle options can have the complication or result in loss of N/A sensitivity and the inability to breast feed. This MUST be understood as a risk. Best to seek only in person evaluations with boarded PSs in private practice. Do you have health insurane?

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your description and pictures, you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations we perform.  Although definitive advice would require in person evaluation, in my practice, I would likely perform the operation with an inferior pedicle technique;  free nipple grafting would not be necessary.

“Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts.

Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts.Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well. Poor scarring, for example may be associated with the procedure. Additional surgery may be necessary in the short or longer term for a multitude of reasons.

When the time is right, I suggest that you seek consultation with well experienced plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with.  Ultimately, careful selection of your plastic surgeon will be the most important decision you make.
To this end, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.

I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

Zachary Farris, MD, FACS · Answer

Thank you for your question and pics.Based on your pics, it looks like that you would need an extensive breast reduction.  I would do a wise pattern incision which would result in an anchor-shaped (inverted T) scar.  This can reliably be done with an inferior pedicle, the portion of breast tissue which the nipple blood supply is based on.  In rare situations where blood supply to the nipple is insufficient as determined in the OR, your nipple complex may be surgically separated as a free nipple graft to ensure viability and proper placement.  As long as you're not a smoker, you should be in good shape for the procedure.  Whenever there's extensive resection, there's always a possibility that you may lose sensitivity or the mild ducts may get transected, affecting your future ability to breast feed.  This is a risk.  Make sure you seek out an experienced plastic surgeon who is board certified by the American Board of Plastic Surgery to go over your treatment options and risks of the procedure.  Good luck!

DDD breasts and very low nipples. What are my options?

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