What is the likelihood of nipple necrosis when combining a lift with implants?

Question

I attended a consultation for a mommy makeover and was advised to only undergo a lift (mastopexy) and then wait a year for an implant due to the risk of “nipple death”. Is this standard? What is the risk of having both done in one procedure?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  I frequently perform a breast lift and implants at the same time.  If good technique is used, the risk of nipple necrosis is extremely low.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Ira H. Rex III, MD · Answer

In many cases, both a lift and augmentation together are safe as far as nipple necrosis is concerned. There are factors that can increase the chance of nipple necrosis, such as smoking, diabetes, previous breast surgery, and others. Your plastic surgeon is the best person to determine the safest way to proceed.

Kenneth Hughes, MD · Answer

I have never even had a partial nipple areolar necrosis after hundreds of breast augmentation and lift combinations.  Although no two patients are alike, I perform breast augmentation and lift together but like to limit implant size to 500 cc or smaller in most cases.  Find the plastic surgeon with elite credentials (education, training, experience, American Board of Plastic Surgery certification) who performs hundreds of breast augmentations and breast lifts each year.   Look at the plastic surgeon's website before and after photo galleries to determine the plastic surgeon who can produce the results you are seeking.  Also read patient reviews.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Christine Rodgers, MD · Answer

HI equestrian,
   If  your breasts are small and if you do not wish to be too large, it certainly is possible to have the lift and implants done at the same time. On the other hand, if you have large breasts and need a bit of a reduction to better shape the breasts and to reduce lateral fullness, your surgeon is being rightfully cautious. Other factors, such as your overall weight, smoking history and medical history also may play a role here as well. Perhaps you should discuss some of these issues further with your surgeon.
Best,
Dr. Christine Rodgers

Peter Hyans, MD · Answer

Nipple necrosis is a very rare complication following a breast lift.  The risk of NN is not increased by placing an implant at the same time.  Most surgeons perform these procedures together however some surgeons prefer these procedures be performed separately.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Fortunately the risk of nipple loss with an augmentation-mastopexy is rare but can occur as a result of the competing forces on a woman’s breast created during the operation - an implant stretching and a lift tightening. In some cases it is wise to stage the two procedures, especially in women requiring sizeable lifts, to minimize this risk.  Seek out second opinions, or post images, for further advice.  Hope this helps.

Camille Cash, MD · Answer

The likelihood of nipple necrosis is very small.  There are certain situations which may elevate the risk to some degree such as circulatory conditions, very large implants, smoking, or high body mass index.  It is quite common to have a lift and implants performed at the same time.  An examination and review of your medical history would need to be done to determine if you are candidate.

C. Bob Basu, MD, MPH, FACS · Answer

Dear equestrian74:The chance of nipple areola (partial or complete) loss is extremely low.  But the patient's past medical history (i.e. tobacco use/smoking history), past surgical history (prior surgeries to the breast), and surgical technique matter.   I perform one-stage augmentation mastopexies on a weekly basis (where the breast augmentation is done at the same time as the lift).  However, there are cases where I will recommend a two staged approach to achieve a much better end result.  For instance, in cases of severe severe sagging (ie. breasts are down to the waist following massive weight loss or severe post pregnancy changes),  I will recommend a lift first and then come back to augment the breasts later.  Sometimes in severe sagging cases where the tissue quality is very poor (poor support), a comprehensive lift is required alone to reconstruct/restore the breast.  Adding an implant can weigh down the lift (even if you are going with a conservative implant) diminishing the overall result.   Each case needs to be evaluated individually - there are NO one size fits all solutions.  Please visit with a board certified plastic surgeon with extensive experience with these procedures to learn more about your options.  Best wishes,Dr. BasuHouston, TX

Gary L. Ross, MBChB, FRCS · Answer

I would ask your PS to show you examples of lifts and implants at the same time and those that are performed in two stages. If the results of one stage are not acceptable to you I would get a second opinion. Nipple death is very rare even in one stage procedures unless you are looking for large implants and need a large lift.

Adolfo Sesto, MD · Answer

Hi. I really do not understand why to undergo a Breast Lift whithout placing the implants at the same time, its easier and quicker to do both. This does not increases the risk of developing Necrosis of the Nipple-Areolar complex.Nipple-Areolar  necrosis is a complication in any Breast procedure, more  when  a  reduction of a gigantic breast is perform due to the long way it has to be move towards the claviculae. It also increases when the patient is  smoker or if she sleeps over her stomach during the first 30 days after the surgery, etc.  Necrosis may occur whenever the blood supply to the Nipple-Areolar complex is insufficient.As you talked also about a Mommy Makeover I do not recommend to combine more than 2 procedures per surgical time not to increase risks of complications. I would recommend Tummy Tuck Plus Lipo and BBL if desire, and in another moment the Breast Lift With Implants. This will permit a good oxigen supply for the tissues manipulated during the surgery.Member of the American Society of Plastic Surgeons (ASPS)

What is the likelihood of nipple necrosis when combining a lift with implants?

Answers (12)

More Mommy Makeover Questions

WE SEND PRETTY
EMAILS

Answers (12)

More Mommy Makeover Questions

How long is too long to keep a Tummy Tuck drain in after surgery? 4 weeks post op.

Should I have done a colonic hydrotherapy one week prior to mommy makeover?

I am having a tummy tuck and breast lift in two days. What is the typical measurement of nicotine that they test for?

Why is acetaminophen more favored over ibuprofen from the PS community?

Retin-A cream on TT scar, Would this help with the scars appearance? (photos)

I had a mommy makeover. Can I take Meloxicam?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS