Nipples too high after implants dropped. What is the surgery like to fix nipple placement? (Photo)

Question

I had a revision done 5 months ago. My nipples pop out of every bra. They appear to be so high. My revision surgery was extremely painful and traumatizing. What does surgery to fix my nipples look like? Could someone please explain the common procedure to correct this? I'm worried about how invasive it is and what recovery is going to look like. Thank you so much!

George Marosan, MD · Answer

Thank you for your question and photos. You are experiencing bottoming out, either secondary to technical reasons or your tissues failed to support the implants. Your nipples are not centered on the breast mound because of this. You will need another surgery to shorten the vertical scar and remove skin in the horizontal plane in the breast crease. You might need your tissues to be reinforced with tissue matrix to prevent this from happening again. This can be only assessed via an in person physical examination. Talk to your surgeon or seek a second opinion from another board certified plastic surgeon. Good luck.

Christopher V. Pelletiere, MD · Answer

Based on your pictures, it appears that the distance from your nipple to the fold of your breast is too long.  This makes it appear that you have more breast/ implant below the nipple and causes the nipple to sit higher in a bra.  The way to correct this is two fold- the first is to raise the implant internally by supporting the pocket with internal sutures.  This would raise the implant slightly to restore more volume above the nipple. As the implant volume comes up slightly, the nipple will appear lower.  The second thing would be to remove excess skin from the bottom of the breast along the breast fold.  This will shorten the distance from the nipple to breast fold, allowing the breast to sit more normal in a bra.  These two maneuvers work well together and would help correct your high nipple/ bottoming out appearance.  I hope this helps.

Curtis Wong, MD · Answer

your lower poles are too long as your photos confirm.  If your original fold is intact, a transverse plication above the fold will correct this and can be redone as your tissue stretches out with time.  If you don't mind being smaller, tissue can be removed rather than simply plicating.  If your fold was lowered, this may have to be corrected.  Am wondering just what your revision did for you?

Jon E. Rast, MD · Answer

Thank you for your question. Based on your pictures it appears that you would benefit from a capsulorrahphy. This requires internal sutures and a release of the upper pocket to raise the implant. Another option is to use an acellular dermal matrix to give the lower part of the implant some additional support.  The downside of the ADM is the cost.

Tom J. Pousti, MD · Answer

I am sorry to hear about/see the problems you are having after breast augmentation/lifting surgery. I think your concerns are  appropriate; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”).

It is probable that you are feeling the implants significantly along the lower poles of the breasts. Patients in your situation often complain of discomfort in the area of implant malposition. Also,  consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low.

I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy (adjustment of breast implant capsules preventing unwanted breast implant movement).  This procedure will serve to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly.  Associated issues with positioning of nipple/areola complexes should improve with this operation.

Make sure that the plastic surgeon who does this procedure for you can demonstrate significant experience with this type of revisionary breast surgery.

I hope this, and the attached link (and video), helps. Best wishes.

Nipples too high after implants dropped. What is the surgery like to fix nipple placement? (Photo)

Answers (5)

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