MTF breast augmentation odd nipple placement: how does one prevent elevated nipples? (Photos)

Question

I have noticed time and time again with trans girls getting breast augmentations come out with their nipples elevated and almost in the sides of their breast. What’s the cause of this and how to prevent this?

Steven Sigalove, MD FACS · Answer

Appropriate nipple positioning is based upon surgical plan in particular, placement of the inframammary incision. Poor incisional placement can lead to a lack of proportionality in the breast and ultimately seemingly improper nipple positioning. Additionally, proper pocket dissection is critical to maintain the position of the implant, and in turn, the ultimate position of the nipple. I typically use scaffolds to support these pockets which leads to better longevity with improved long term implant and nipple position.

Dallas Buchanan, MD · Answer

Thank you for your questions! This is a very astute observation and something that needs to be evaluated ahead of surgery. This is generally a result of the differences of male vs female anatomy. Female NAC tends to be centered on the chest, larger, and round. Male NAC tend to be inferior and laterally displaced on the chest and smaller and oblong in shape. So when an implant is placed centrally on the chest to create cleavage and a feminine contour in clothing, the nipple is going to appear displaced. Some of this can be corrected with partial movement of the nipple and some of it cannot be corrected if the anatomical differences are significant enough and just has to be accepted. It really depends on each patient's unique anatomy. Make sure you are seeing a plastic surgeon who is board certified by the American Board of Plastic Surgery.

Hope this helps!

Dallas Buchanan, MD, FACS
VIVIFY plastic surgery

Hope this helps!

Dallas Buchanan, MD, FACS 
VIVIFY plastic surgery

Zoran Potparic, MD · Answer

It is known fact that nipples and areolas (NAC) are positioned lower and more on the side in male patient in comparison to female nipples. For that reason, when breast augmentation is done and implants placed in central position, nipples look  dislocated laterally (on the side) instead of being centred on the top of new breast mount. Hope this helps.

Daniel Barrett, MD · Answer

Dear babyveee,
it is hard to tell for sure without an examination. 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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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