Nipples Sit Higher Than Pre-BA Due to Bottoming Out, Fixable with Explant? (photo)

I had 350cc silicone unders placed 7 months ago and am explanting soon. (I'm 25, no kids, don't smoke, slender/athletic.) The implants have bottomed out and my nipples sit higher than pre-BA (it's not just the appearance, they really do). My surgeon is performing a capsulectomy, reattaching the chest muscle, and lifting the IMF. My question is whether the nipples will return to their pre-BA spot or if the have "healed" in a higher position? I'm worried my post-explant breasts will look deformed.

Doctor Answers 3

High Riding Nipples

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Healing can be unpredictable.  Removal of your implants and resetting your fold should place your nipple back in better position.  

Dr. ES

Implant Descent is Correctable with Internal Sutures to Raise the Inframammary Crease

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Your nipple-areolar complex position is (too) high on the breast mound because the implants have settled to a position that is too low. Your incision (scar) was either placed within your previous inframammary crease, or lowered a bit to accommodate the implants.

To my eye, it appears that your incision was correctly made lower than the position of your (pre-op) inframammary crease specifically to accommodate your implants, and was intended to be the new position for your inframammary crease post-op. If all goes as planned the scar lies within the new inframammary crease formed at the bottom of the implants after they have settled into place. However, your implants have settled too far. Because the nipple-areolar complex position is fixed, it becomes higher and higher on the breast mound the farther the implant settles below its desired position. The risk for malposition with breast augmentation is probably about 5%.

To correct this problem the implant is removed, a small portion of the inferior capsule is excised (inferior capsulectomy), the inframammary crease is reconstructed with internal sutures, and the implant is replaced. This will place the scar back in the crease, raise the implant position, and the nipple-areolar complex should be more properly positioned over the center of the breast mound. You do not need to worry that the nipple-areolar complex has healed in an improper position. If you choose to have your implants removed, the procedure is nearly identical, as you have described, and should correct the problem. You do not have to worry about having a deformed breast after explantation.

It is unfortunate, by the way, that you have found the need to explant so soon after your augmentation.
Best wishes,
Ken Dembny

Fixable with Explant?

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The implants, especially when low can rotate the nipples forward and upward on an arc. It sounds like the plan you outline should restore the normal nipple position. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.