Nipples too high after breast reduction, can this be corrected? (photo)

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.

Doctor Answers 12

Nipples Too High after Breast Reduction?

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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.

Nipples are too high after breast reduction surgery

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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.

Fredrick A. Valauri, MD
New York Plastic Surgeon

High nipples after breast reduction can be improved.

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1)  It looks to me that the main problem is that the folds under the breasts are too low (bottoming out).  So the nipples are not centered on the breasts and they look quite high. ( And they are also slightly high in reality.)

2)  This is not uncommon when skin tension is used to shape the breast, because skin stretches.

3)  A revision vertical breast reduction (in which the breast tissue is shaped and repositioned internally) should give you a more balanced shape without having to actually lower the nipples (which is very hard).

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Nipples too high after breast reduction. What can be done?

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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.

Excessive length between the areola and inframmary crease common after scar sparing breast reduction.

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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.

Revision of breast reduction

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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.

Nipples Too High Following a Breast Reduction Surgery

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I think your plastic surgeon is correct that this condition can be corrected by shortening the distance from your nipple to the inframammary crease.  You have a bottomed out appearance and can be due to some secondary laxity of the skin following the initial surgery.  When there is too much breast tissue in the lower half of the breast this pushes the nipple up to an abnormally high position.  It is then not unusual for the nipple to poke out above your bra.  Time for a relatively minor revision to correct the problem.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Too high nipple after breast reduction

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Actually it is very difficult to 'lower' the nipple after a breast reduction, however the approach for most of us would be a removal of the tissue below, and removal of skin below to 'pull' the nipple down over the front of the breast. There is a risk to the circulation of the nipple with secondary reduction and revision, so you should be certain you are working with a board certified surgeon expert in reduction.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

You need an in person consultation

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Are your nipples too high or is your breast tissue too low. That is why you need to be seen and evaluated first. IF the nipples are too high -- that is a bad problem, lowering them will leave visible scars above them. Good luck

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Nipples to high, can this be corrected?

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Yes, it can be corrected but like your surgeon suggests it will entail removing more tissue and lifting the remaining while the nipples maintain their current position, good luck

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.