Is there a high risk of losing your nipple if you have a second breast lift without knowing where the original cut was?

You should know the blood supply based on where the scar is.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Thank you for your question. This is a very pertinent question, and you will probably see multiple different answers. In my opinion, the blood supply doesn’t matter. I have read surgical papers that say that it is a relevant, but I have seen firsthand compromised and dead nipples after a mastopexy from other surgeons.I think finding a surgeon who has experience in revision breast work as well as one who has a healthy respect for the blood supply to the nipple will land you with excellent results.

your question is an excellent one and one we often have to wrestle with.  There are so many variables involved such as the type of lift originally dome, how far the nipple needs to be moved and the thickness of the breast tissue which provides the blood supply.  Your surgeon needs to take all of these things into consideration when planning and performing your second lift to make sure the risk of nipple loss is kept to a minimum.

Hello,
As a resident in plastic surgery in the 1990's, I have indelibly etched in my mind my teacher's admonition about revision breast reductions and lifts and nipple safety. Fast forward a quarter century and nearly a thousand revision lifts/reductions, and I can assure you that the blood supply to the nipple is almost irrelevant, especially with today's modern techniques like the central pedicle, which preserves a wide range of blood vessels to the nipple during the revision lift. Go visit a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. BTW, contrary to one surgeon's answer, the scar does not reveal the original blood supply to the nipple, but that's ok, because like I said, it really doesn't matter, especially years later. Best of luck!

Yes, that is true that having a second breast lift without knowing what pedicle was used in the first surgery can involve an increased risk of compromising blood supply to the nipple. The Wise pattern incision used for a full breast lift does not indicate which pedicle was used. This is determined by what was done inside, and how the blood supply was maintained. However, if many years have passed, while there is an increased risk, it is not so high that one cannot get another breast lift. If you are able to get your old operative report it would be helpful. I would recommend seeing a board certified plastic surgeon with experience doing secondary breast lifts, and see if you are a good candidate.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  I highly recommend ensuring that your surgeon has performed many breast lifts in this same situation before.  It is not possible to know the blood supply to the nipple based only on the skin incision without a previous operative report.  I always recommend a central mound technique in order to preserve as much blood supply to the nipple as possible.   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

Dear debigrechyn,revision surgery is always more complex than initial surgery, especially in cases when you don't know what was done previously. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. You will get the best recommendations after a thorough examination.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Loss of the nipple areola complex after a second breast surgery can occur from impaired blood flow to the nipple areola complex.  Without knowledge of the pedicle or segment of tissue (containing the blood supply) supplying the nipple areola complex used in a prior surgery, it is possible that it could be inadvertently cut at the second surgery.  If at all possible, it is advisable to obtain prior records.  If obtaining prior records is not feasible, the plastic surgeon may resort to choosing a pedicle or segment of breast tissue in which to carry the nipple areola complex that he/she may deem safest. Best wishes. 

To answer your question, there is a slightly higher risk of wound healing complications and partial or complete nipple loss when a second lift or reduction is performed.  However, if it has been many years since your previous surgery, it is likely that the nipple areola complex has re-developed its blood supply.  And a surgeon may alter his or her technique slightly to ensure that the nipple areola complex maintains an adequate blood supply for a secondary surgery.   In general, I do counsel all of my patients about the slightly higher risk under these circumstances but have found that with good surgical technique and good surgical candidates (non-smokers), the risk is very low.  I would suggest that you consult with a board certified plastic surgeon to discuss your options.  Good luck!

Thank you for your question.  I perform revision breast lifts all the time and patients don't loose their nipples.  That being said there are extra risks involved with a secondary lift but if you go to a surgeon who performs a lot of revision breast lifts and complex breast surgeries your risks should be minimized.  Best of luck to you