How many procedures for stretched skin, augmentation and inverted nipples? (photos)

Question

I have thin, loose skin on my breasts from two pregnancies that brought me up several cup sizes and I also have inverted nipples, so there's a lot going on here. I'm not as concerned about the stretch marks, but trying to get a gauge on how many procedures it might take for augmentation and a possible correction of the inverted nipples? Currently at a B cup but breasts went to an E while pregnant.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. So if you were to get a breast augmentation it will fill in the areas that have deflated during breast feeding and that would include your nipples. If you still have excess skin you maybe are in need of a lift along with your implant. This can be a one step procedure or otherwise a two step surgery if you want. Its really up to the plastic surgeon who is performing it. Best of luck!

Wayne I. Yamahata, MD · Answer

I personally would recommend staging your procedures and treating the inverted nipples after you have fully healed from the breast augmentation. The benefit of adding a lift cannot be ascertained with the photos you have provided, but if necessary, it can generally be done at the same time as the augmentation.

Gianfranco Frojo, MD · Answer

Based on your photos you would likely need an implant and a lift. Most of the time an implant alone will address the inverted nipples but if not, there are procedures that can be done at the same time. You need to see a board eligible or board certified plastic surgeon to ensure an adequate history and physical exam is obtained / taken. Only then can you appropriately provide treatment recommendations for a patient.

Michele A. Shermak, MD · Answer

Hello!
Gold standard answer for management would include an augmentation with implant + lift which can be done in single stage. I personally would hold off on inverted nipple repair to second stage to best protect nipple healing.  If you are willing to go with a fuller implant you might be able to avoid the lift. I would recommend you see a board certified plastic surgeon in consultation. You can reach one at plasticsurgery.org. 
Best of luck to you!

Gary M. Horndeski, MD · Answer

The technique I recommend is 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. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Wess Cohen, MD · Answer

Thank you for your question. In terms of reshaping your breasts, the number of procedures depends on what you want your final result to be and if you want to use implants, or utilize fat grafting. Your options are either in augmentation mastopexy, utilizing implants. Or an auto augmentation mastopexy, where your own tissue is utilized while performing a breast lift. Both of these procedures can be combined with fat grafting. These procedures can either be done in one or two stages, however if fat grafting is utilized and you desire a significant volume enhancement, you will need multiple sessions.
Correction of the inverted nipples can be done at the same time. Or even as an office procedure. I

Ronald J. Edelson, MD · Answer

You need a lift and implants. Could be done together. I would do the inverted nipples at a second procedure  or not at all. Sometimes an implant behind the breast tissue will improve the inverted nipple.

Daniel Barrett, MD · Answer

Dear Calbee,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Just based on your photos, you could do the breast augmentation initially, and then come back for a minor procedure in the office on the inverted nipples if the augmentation failed to evert them.

Camille Cash, MD · Answer

From your photos it appears that you could have a nice result in one stage.  An in person evaluation is always best but depending on your goals and implant selection, you may be able to have augmentation alone or a more conservative lift.  The next step is to visit with a board certified plastic surgeon near you for a consultation.

How many procedures for stretched skin, augmentation and inverted nipples? (photos)

Answers (12)

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