Why Are my Nipples So Low? (photo)

Question

I had breast augmentation surgery 9 months ago ,and, while I am happy with the size, my nipples are still a bit low. My surgeon said he was going to lower my creases during my procedure, but I'm not sure if it was actually done. I have included photos and I'm wondering if this is the expected result . Would there be any procedure possible to make them higher? If so, would it be worth it to try to fix them or are my results considered acceptable? I have 425cc HP implants under the muscle.

Ali Sajjadian, MD, FACS · Answer

Hello,

	Thank you for sharing your before/after photos.

	It seems like your HP implants were placed in a may where they are not "centered" behind the nipple but a little superior to it hence your nipples are pushed a little inferiorly.

	If you desire a correction, then a Benelli lift (doughnut lift) could be the least invasive but will leave your with scars around the areolae.

	I hope this helps. Thank you for your question.

	Dr. Sajjadian

James F. Boynton, MD, FACS · Answer

In reviewing your photographs, it looks to me like you have a nice postoperative appearance. The nipples are not perfectly "centered" on the breast mount after surgery - but they were not before surgery either. I often point this out to my patients and explain that an implant increases the size of your breast; however, it does not "lift" the nipple position (with respect to the breast). The only way to really do that is with a breast lift or mastopexy. I think you have a nice result and I would not at this time choose a breast lift. I also would caution you from considering any "fold lowering" procedure that attempts to "lower" the implant. That can put you at significant risk for "double bubble" deformity , etc. , which can be hard to fix. I hope this helps!

Michael Horn, MD · Answer

You have choices. Many women would be extremely happy with the way you look and not change a thing. The implants will still get a tad lower with time. If you like the position of your implants, you could do a peri-areolar lift (around the nipple). This lift would place the nipple more centrally on the breast but would result in an incision all of the way around the nipple. Conversely, you could lower the space which the implant is in. In this way the nipple would be more centered on the implant, but you would have less fullness on the top which you may not want to loose. I suggest meeting with your surgeon to discuss these pros and cons.

Stewart Wang, MD, FACS · Answer

It appears that your nipples are positioned just below the horizontal midline plane of the implant. If you like where the implants are positioned (fullness of the upper pole then the only way to further improve the implant/nipple relationship is to elevate the nipple/areola. This can be achieved with a donut or Benelli breast lift. The trade off is a scar around the border of the areola. If you want to keep the nipple exactly the same position then you have to lower the implant to make the nipple appear more centered on the implant. When you lower the implant then you may lose some of the fullness of the upper pole that you come to like. Final option is to stay the way you are currently and enjoy the newly enhanced breasts. This is a good discussion to have with your plastic surgeon during your next follow up visit.

	Best Wishes,

	Stewart Wang, MD FACS, Wang Plastic Surgery

Norman Bakshandeh Day, MD, FACS · Answer

You have a nice result. The fullness on the top is a reflection of the style of implant that was used. The high profile implants have this kind of look.

Darryl J. Blinski, MD · Answer

Your result loks very good but your happiness is paramount. I might consider a donut lift to elevate the N/A complexes.

Steven M. Lynch, MD · Answer

Hi,

	  Your pre op photos tell the story.  You have nipples that are somewhat outward pointing and the left nipple complex is lower.  All of this shows up in your pre op photos and now you are seeing them post op.

	  You have a very attractive result.  However, if you are bothered by the nipple position, then you can easily raise the nipple complex but of course it is a tradeoff with the scars that would be around the nipple complex.

	  You may still get some bottoming but at 9 months, you probably will not change too much with the nipple position.  It is hard to determine if your surgeon lowered the crease but I think the position of your creases is close to the preop position.  If you were my patient, I would reassure you of your options but I would also caution you to risk anything with your pretty result.

	            Steven M. Lynch, M.D....Albany, New York

Peter E. Johnson, MD · Answer

Your result is nice, however the nipple is pushed low by the size and projection point of the implant. The HP implant you have is causing the present look because the implant projection is just above the nipple and not centered on it. A solution is a smaller moderate profile implant, or a pocket which is slightly lower and centered on the nipple.

Gregory Pastrick, MD · Answer

I think you have a very good result. The reason your nipples look a little low is because the position of your nipples is below the horizontal midline of the implant. Due to the curvature of the implant, nipples below the horizontal midline will appear to be low or pointing downward and the upper part of the breast appears fuller. The opposite is true for nipples above the implant midline; they appear to point up and the implant appears "bottomed out". Your issue is correctable by lowering your implant, ideally, to position the nipples in the horizontal midline of the implant. This is much easier said than done in your case because controlling how the implant settles after a revision by releasing the inferiorior capsule of the implant, breast tissue, or even the inframammary fold is very difficult and somewhat unpredicable, especially on both sides symmetrically. After release, the bottom part of your breast could stretch too far under the weight of the implant and cause bottoming out. Based on the photos, I probably would not recommend any revision since the result from your augmentation is overall very good and often the enemy of good is perfect. Hope this helps.

Jourdan Gottlieb, MD · Answer

If you feel that raising the nipples by perhaps 2 cm (0.8 inch) would improve the appearance enough to have an incision(and subsequent scar) around the areolas, then it is worthwhile. 

	It does look to me that the folds are lower in the afters, but with the size of your implants, most of the implant is in the upper part of the breast. 

	To my eye, this is acceptable. But your eye is as good as mine. If you do wish to think about a lift, ask you surgeon to show you some photos, and ask if these are typical scars or just the best ones. 

	Thanks for your question, best wishes.

Why Are my Nipples So Low? (photo)

Answers (13)

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