Are my nipples supposed to be facing down? PLEASE help! (Photo)

Question

Im almost 2 weeks post op and very concerned. I had a breast augment , went from a b to c and my nipples look horrible. my entire breasts are sore and incredibly hard. Ive been wearing a bandeu since day 4 but im very sad and scared. My nipples look huge and puffy.

Brian C. Reuben, MD · Answer

Thank you for your question and photo.  Unfortunately it is difficult to determine what is going on from that angle and single photo.  At times the implants can ride high.  This alone can make the nipples point down.  The implant needs to be centered under the nipple to prevent this from happening.  The implants may settle but best advice is to follow up with your surgeon.  They can help guide you through the recovery process.

Alejandro Nogueira, MD · Answer

Please post better and complete set of them; by this it seems your implants might have been located too high.

David C. Yao, MD, FACS · Answer

Thank you for asking. Talk with your plastic surgeon. Swelling may be considerable in some patients depending on the type and technique of surgery done.  You should be seen in person with the pre-op photos available for comparison. It has been 2 weeks but more time alone can help. Best wishes

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question, it is surprising how much the breasts acomodate and change to implants after surgery, you will need to allow for the implants to be acomodate by the breasts, typically the nipples swell

Robert M. Tornambe, MD · Answer

I understand your concern.  It is difficult to answer without seeing you in consultation and evaluating your pre-op photos. It is extremely early in your post-op course, but talk to your surgeon.  If you are still concerned, seek a second opinion from a board certified plastic surgeon.

Larry Weinstein, MD · Answer

There are a certain percentage of implants that need time to settle. A superior compression band may help. compression exercises to the superior pole may also help if they are smooth implants. Textured implants will probably not shift when they are displaced superiorly. The combined breast lift/ augmentation procedure has a 20% rate of need for revision surgery.

Angela Champion, MD · Answer

It's not uncommon for nipples to be facing down at this point post-operatively since you are only 2 weeks out.  As your implants drop, your nipples will gradually move up to a more central location on your breast mound.  Over the next few months, they will soften and you will notice the shape changing and rounding out as the lower portion of your breast fills out.  Definitely talk with your surgeon about your concerns, but be patient and closely follow post-op instructions.  ac

Robert Drielsma, MBBS, BSc, FRACS · Answer

Breast tenderness and firmness at this stage of your post operative recovery is to be expected.  The angle of your photograph makes it difficult to asses your results and review of your pre operative photographs would be very helpful.  Nipples ideally should be slightly tipped up following aesthetic breast surgery and I would say you probably should have had, and now need, a lift to improve your appearance.  If you have concerns you should raise them with your plastic surgeon.

Robert L. Kraft, MD, FACS · Answer

This question cannot be answered without viewing preop photos.  If your nipples pointed downward to begin with by an appreciable amount and you did not have an augment/pexy, then this could be the consequence.  Assuming that you had a circumareolar procedure, then two weeks postop is not the time to make judgments as to the final outcome as to the nipples.  Nevertheless, I would encourage you to reach out to your plastic surgeon and discuss your concerns.  If part of the issue is basic postop healing, this may allay your concerns.

David L. Cangello, MD, FACS · Answer

Unfortunately it is difficult to say much given the view your photo was taken from. It would also be helpful to know how you looked preoperatively to know if a lift would  have been needed in your case along with the implants. I'm guessing that it probably would not have though. It is very early in the healing process for you. Your only option would be to wait at this point as nothing can be done surgically. Try to be patient and wait about 3 months to see where the implants end up. You may be in better shape. If not, you may discuss with your surgeon options or seek a second opinion.

Are my nipples supposed to be facing down? PLEASE help! (Photo)

Answers (11)

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