Exploring Breast Augmentation: Is a Nipple Lift Necessary? (Photo)

Question

I am a 30-year-old woman, standing at 5'7" and weighing 168 lbs. My goal is to enhance the perkiness of my breasts without significantly increasing their size. I'm particularly interested in adding volume to the lower part of my breasts. During a recent consultation, I also expressed a desire to have my nipples positioned higher.

Daniel Barrett, MD · Answer

Dear pativrgz17,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Richard Zienowicz, MD · Answer

Hello and thank you for your question. You have a few options that you could pursue for increasing volume in your breasts and changing the nipple position on the breast. Your surgeon should be able to discuss the different options and the benefits and risks of each.

For the most symmetric result that keeps your implants at a more modest size, I would recommend a donut mastopexy, or donut breast lift, aka a circumareolar mastopexy. This is when a ring of tissue is removed around each areola to slightly lift the areola and improve symmetry. Currently your left areola is lower than your right. This, along with a modestly-sized breast implant, would provide a rounder, perkier shape with improved symmetry with the areola. The scar is hidden along the edge of the areola. Through this incision the surgeon can also address the tuberosity of your breasts and place the breast implants.

It does appear as if you have mild tuberosity of your breasts, which is when there is a slight cone-shape to the breasts. At times this tight tissue has to be treated with surgery as well and could be performed as a part of your augmentation. The implant would help expand and round the shape of your breasts as well. There are different "profiles" of implants and your surgeon can help discuss which option is best for your goals and your anatomy.

Gary M. Horndeski, MD · Answer

At 5'7 and 168 lbs, your BMI is 26.5 so you should have fat available for donor if you want to add more volume to the lower part of the breasts.  At the same time, you can undergo a mini lift.  Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage.

Harry T. Haramis, MD, FACS · Answer

Moderate sized implants with some internal tissue release will enhance perkiness. This will also increase lower pole fullness. A lift is not required.

An exam and consultation with a plastic surgeon is recommended to confirm this as well as discuss your options and expectations.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Camille Cash, MD · Answer

From the provided photos you have some constriction at the bottom portion of your breast.  In order to achieve your goals of higher nipple position and more fullness at the bottom of the breast you will need to consider a lift.  Implants will help to stretch the lower pole as well.  See a board certified plastic surgeon near you to learn more.

Francisco Rodriguez Rosario, MD · Answer

El levantamiento de pezones, también conocido como mastopexia de pezón, es un procedimiento quirúrgico que se realiza para corregir pezones caídos o invertidos. Sin embargo, no es necesariamente parte del proceso de aumento de senos, ya que el objetivo principal del aumento de senos es aumentar el tamaño y la plenitud de los senos, no necesariamente corregir la posición de los pezones.
En muchos casos, el aumento de senos por sí solo puede mejorar la apariencia de los senos y proporcionar una apariencia más completa y juvenil. Sin embargo, si la paciente también tiene pezones caídos o invertidos, puede considerar someterse a un levantamiento de pezones en combinación con el aumento de senos para obtener los resultados deseados.
Dr. Francisco Rodriguez

Connie Hiers, MD, FACS · Answer

With adding volume, your nipples will move up some. I would suggest not doing an actual lift for now, and I think you would be happy. However, if you do choose to lift your nipples, please do not move them too high.  Your surgeon can guide you in this.

Mats Hagstrom, MD (license on probation) · Answer

Based on your pictures, you do not need a breast lift.
Your nipples are in a good position and I see no need for changing nipple position.
Recognize that implant augmentation is going to make your breast bigger.Implant selection is very important, and each provider will have their own way of guiding patients through this process.
Generally speaking modest size, low profile implants are probably the way to go if you want a more conservative, natural appearance.
I suggest having multiple in person, consultations with plastic surgeons in your community to find the right provider for your needs.
 There’s no correct number of consultations needed to find the right provider.
Being board-certified in plastic surgery with years of experience does not mean somebody has mastered any single procedure.
There is inherent difference in skill and experience among a different plastic surgeons.
Some providers are inherently better at this procedure than others.
 There are generally three variables that determine the outcome of breast augmentation surgery.
The first variable is the patient candidacy for the procedure. The second variable is the selection of implants in regards to size shape, and type.
The third variable is the surgeons ability to place the implant in the correct anatomic location.
 All of these variables are important.
Patients do not generally have much choice regarding their own candidacy for the procedure.
Based on your picture you look like a very good candidate for breast documentation.
Implant selection is best done with your provider.
Like I mentioned some providers, do this better than others.
 in the end, most likely the most important decision is provider selection.
To find the right provider I suggest patient interview or consult with a few of them.
Take care for notes during each consultation.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own.
 An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients.
Being shown a handful of pre-selected images, representing only the best results of a providers career may be insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results are likely to look like or how many of these procedures they’ve actually done.
Bring pictures of yourself and use those as a reference during the consultation especially when reviewing before and after pictures.
People often do not remember exactly what they look like.
Ask each provider what their most common indication for doing revision surgery is, what their revision rate is, and what their revision policy is.
All plastic surgeons do revisions.
Claiming to have zero or very low revision rates probably means that patients are not getting the best possible outcome.
What’s more important to understand is what the most common indication for revision surgery is.
the single biggest problem patients want to avoid that is due to technical error is implants being placed too low, causing bottoming out.
This is an undesirable outcome that is directly related to how the procedure was performed.
There’s no correct number of consultations needed to find the right provider.
Sometimes it’s simply based on lock.
The more consultations patient schedule the more likely they are to find the better provider.
The biggest mistake patients make is having only one consultation, then scheduling surgery.
Having only one consultation, more or less eliminates the ability to choose the better provider.
 Find the right plastic surgeon and everything falls into place.
Best,
Mats Hagstrom, MD

Karidy Reyes, MD - Account Suspended · Answer

Whether a nipple lift is necessary during breast augmentation depends on several factors, including the degree of nipple ptosis (sagging) and the desired aesthetic outcome.
In certain cases, if the nipples exhibit only slight drooping or if the breast implants can provide sufficient support to elevate the breasts, a separate nipple lift procedure may not be deemed necessary. The augmented volume and projection from the implants can, at times, naturally result in a lift of the nipples.
However, if the nipples display significant drooping or a downward orientation, a nipple lift may be recommended to attain a more aesthetically pleasing outcome. During a nipple lift, surplus skin is excised, and the position of the nipples is adjusted to a higher and more youthful placement on the breast mound.
Ultimately, the necessity for a nipple lift will be determined during the consultation with your plastic surgeon. They will evaluate your breast anatomy, engage in discussions about your goals and concerns, and propose the most suitable surgical plan to achieve the desired outcome.

Exploring Breast Augmentation: Is a Nipple Lift Necessary? (Photo)

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