Hello, I had a breast reduction 7.5 months ago, I'm pleased, however my nipples are too high, I want to know what risks are involved with having them lowered a bit, as well as how invasive the procedure for this would be. It's something I could live with, but it's uncomfortable and if I wear certain bras or shirts my nipples peek out the top. I also want to have a little more breast tissue removed. I contacted my Dr. about it and he said he would tighten the lower aspect and remove more tissue.
Answer
The picture shows that your nipples are a little too high. I usually like to place the nipples slightly above the fold under the breast and about the level of mid arm. It is not easy to lower the nipples because it would leave a scar above the areolas. In your situation I would remove a piece of skin and breast tissue transversally above the lower breast folds. This will reduce the breast size and reduce the distance between the fold and the nipples. If done properly it can increase the fullness above the areola, improve the bottomed out look and lower the nipples a bit. Good luck.
Dr. Farhad Rafizadeh, MD
Board Certified Plastic Surgeon
Answer
Operations that try to limit incision length may have unwanted consequences. The excessive length between the areola and the crease of the breast is commonly seen with operations that do not have a horizontal component along the inframmary crease.
Dr. Vincent N. Zubowicz, MD
Board Certified Plastic Surgeon
Answer
Your question is how to treat nipples that are too high after breast reduction surgery.
Your photos show that the lower part of your breast has "bottomed-out" and it is because of this that your nipples have rotated upward.
This cause for high nipple positon can be improved with a modified breast reduction procedure which excises additional breast and skin removal only from the lower half of your breasts. While there will be a modest reduction in your breast size,you will have a more natural position of your nipples.
Answer
Thank you for the question and pictures.
It sounds like your plastic surgeon's plan is a good one; removing additional skin/tissue along the lower poles of the breasts should help center the nipple/areola complexes (on the breast mounds) so that they do not appear to be “stargazing”.
Best wishes.
Answer
The most appropriate way to address this situation is to excise additional breast tissue between the nipple and infra-mammary crease. This can be due to loose skin in the lower quadrant of the breast creating a bottoming out situation. You should discuss with your surgeon whether this would require sedation and financial responsibility as such a revision would not be covered by health insurance.
Dr. Robert L. Kraft, MD, FACS
Board Certified Plastic Surgeon