Breasts positioned low on the chest & reduction challenges.

The place that a woman's breast is positioned on the chest wall is called the footprint of the breast.  In some women the footprint is lower than others and surgery does not change it significantly.  Ptosis, or "drooping" of the breast is defined as a nipple that's positioned on the breast lower than it should be.  Ideally a nipple should be centered on the breast mound and positioned above the level of the crease under the breast (the inframammary fold).  It seems your surgeon told you that you don't have ptosis, as your nipple is well positioned, but that your footprint is lower than you'd like.  With regard to breast reduction surgery, most of the time the skin and breast tissue removed is from the lower part of the breast, but breast tissue can be removed from the other parts of the breast as well.  The resultant shape and perception of the nipple seeming low may be influenced by the technique used.  A vertical breast reduction wouldn't remove as much lower breast skin and may not make your nipples seem lower than prior to surgery, but without having examined you I can't commend as to whether this technique would be appropriate for your breasts.  I think when considering breast reduction surgery, you have to consider your priorities.  Obviously all patients want their breasts to be as beautiful as possible after surgery, and I'm sure your surgeon does too, but there are limitations to what surgery can achieve based on the patient's anatomy.  If you were hoping for breasts that sit higher on your chest, that's probably not a realistic expectation.  If you have back, neck, and shoulder pain for which a breast reduction is recommended and could make a huge improvement in your quality of life, less roundness and nipples that seem a little lower may be a price you're willing to pay.I'd suggest a second opinion to see what another plastic surgeon thinks about the shape you can achieve with breast reduction surgery then it's up to you to determine if the benefits of surgery are worth it to you.

I can not say without seeing photos and performing an exam in person.  For most patients lifting the nipple and reducing the volume are common. It is rare not to have to raise the nipples.

Without a photo it's hard to say, but some patients just naturally have breasts that "sit" lower on their frames.  The breasts can have an appearance of droop as there is excess breast tissue at the bottom of the breasts.  When a plastic surgeon performs a breast lift or reduction (which is just a breast lift and removal of a considerable amount of breast tissue), he/she first considers where the nipple/areola should be positioned.  The rest of the breasts is then shaped according to this location.  In your case, it sounds like your nipple/areola are in a desirable location.  The rest of your breast just needs to be reduced and shaped.  As far as the roundness of the breast, you may have to opt for a lesser reduction that you'd like to allow for that shaping to result.  Consult with your plastic surgeon in this regard.  Good luck!

Hello and thank you for your excellent question. Many women have concerns about their breast shape and nipple position after a reduction surgery. To really give you an accurate answer, you will need in in-person consultation.  Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 


Best,

Jon Ver Halen, MD FACS 

Harvard educated plastic surgeo