PO My nipples are too high after breast reduction, what are my revision options? (Photos)

It is difficult to say definitively without seeing photographs of the incisions, and seeing the length between the areola and the breast fold. Typically in cases like this, a wedge of skin and fat needs to be removed along the breast fold, and this allows the nipple to be moved downwards.

During breast reduction, your surgeon removed excess tissue and skin to make your breasts smaller, and then moved the nipples up in position to give them a lift. The skin envelope can probably be reoriented to lateralize the areolae and improve symmetry. Ask him in a nice way to perform the revision.

Years of experience and good training, have taught me a few things. One thing is envisioning nipple position around 6 months after surgery. We purposely put the nipples a little low during surgery since the breast will drop during healing and push the nipples up. The nipples can be relocated but it can be a little tricky. Make sure to see a board certified plastic surgeon.

If you are still having back pain then the volume of the breast is greater than the mechanical strength of the skin envelope to support it. You will need a revision of the reduction. The technique I recommend is The Bellesoma Method. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Dear seyanab,
it is hard to tell for sure without an examination. BAsed on your photos, it looks like you would benefit from a revision surgery. 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

From the submitted photos I can appreciate your concern. Your nipple position is too high. The only way to correct this is a revision. If desired you can elect to have more tissue removed at the time of your revision. I'm sorry your surgeon hasn't been helpful. I encourage you to visit with another board certified plastic surgeon near you if you are unhappy with your original surgeon.

Without a topless photo, I can't tell if it is truly nipple malposition (incorrectly measured location) or the more common bottoming out of the breast tissue. When this happens, the "too much" breast tissue at the bottom of your breasts fills up the cup of a lady's bra and the nipples peek above the bra fabric. A correction might be to tighten just the skin of the lower part of the breast, or it might be that plus removal of some of the breast tissue that is inferolateral (down and out), or it might take a complete re-do of all of the scars (plus skin and tissue removal). The goal is that if you can't lower the nipple to have it in the center, then you try to raise the breast to bring it up.

In the photos, the position of your nipple areola complex seems to be too high. Fortunately, there are revision options available. Would contact another board certified plastic surgeon and get a second option.

This is a poorly measure breast reduction, now the one method is a reversal using full thickness skin grats to lower the N/A complexes.Very few boarded Plastic Surgeons have done this. In over 40 years of pracrice I have done this revision twice. The down side is the superior skin graft scars. Research and see a few boarded PSs in your area. Good Luck and Stay Safe

A revision breast lift would help shorten the distance from your nipple to the infra-mammary fold (crease under your breasts) which would give you more upper pole or upper breast fullness/roundness and center the nipples lower on your breasts to enable you to wear the bra/dresses you desire.
Best of luck.
Dr T