Are my nipples too high? If this is normal, when will my nipples drop? And if this is not normal, what can I do to fix it?

Question

I got high profile 400cc gummy bear implants 1.5 months ago. I started at a 32a/b (I'm 5'1 and 100 lbs) , and while I love the size, my nipples look too high and stick out of every bra (and low cut shirt) I have. If this is normal, when will my nipples drop? And if this is not normal, what can I do to fix it?

Tom J. Pousti, MD · Answer

I am sorry to hear about/see the problems you are having after breast augmentation surgery. I think your concerns are appropriate; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”).
It is possible that you are feeling the implants significantly along the lower poles of the breasts. Patients in your situation often complain of discomfort in the area of implant malposition. Also, consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low. 
Generally, signs of breast implant bottoming out include: 
1. Breast implant "sits" too low on the chest wall.
2.  Excessive palpability or visibility of the breast implant along the lower breast pole.
3.  Nipple/areola complex seems to be sitting relatively high, because the breast implants have settled too low. 
4. Discomfort along the lower breast pole (secondary to pressure from the underlying implant).
5. Relative paucity of upper pole breast implant volume compared to lower pole volume.
6. Increased visibility of a infra mammary fold scar (higher on the breast mound).
I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). Sometimes, depending mainly on the patient's history and physical examination, I will also use additional supportive materials such as acellular dermal matrix or biosynthetic mesh. This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes and visibility of the inframmammary fold scars should improve with this operation.
 I hope this helps.

Charles Nduka, MD · Answer

Based on the photo, you may have had implant size that is too large for the chest wall measurements you have. Nipple revision surgery is an option. It seems like your breast implants have started to bottom out, but it would be difficult to conclude without an in-person examination. The best resource of information would be your board certified plastic surgeon as he/she knows your condition best.

Brian A. Pinsky, MD, FACS · Answer

Based on your scars, it seems that you had a primary breast augmentation without a lift.  In this scenario, your nipple position does not technically change.  However, it looks like you have implants that are too large given your narrow chest and the pocket was possibly over dissected to accommodate the larger implants.  Consequently, the implants are now migrating down (bottoming out).  This gives the nipples the appearance of pointing upwards event though the absolute measurements have not changed.  Unfortunately, there's no good fix other than revision surgery.  I would downsize your implants and perform a capsulorraphy to control the implant position possibly adding a mesh product for reinforcement.  I would recommend going back to your surgeon or seeking a second opinion if needed.  Best of luck!

Are my nipples too high? If this is normal, when will my nipples drop? And if this is not normal, what can I do to fix it?

Answers (3)

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