Both nipples are now misshapen and one is stretched out. (photo)

Would nipple correction surgery be a cost to me or is this his fault? I had breast augmentation through a nipple incision 5 months ago. One breast Is also larger than the other.

Doctor Answers 1

Misshapen nipples and asymmetric breast sizes after breast augmentation via periareolar incisions.

Wow, you sound pretty judgemental and "blaming." But, it's hard to know by simply reading a short, terse question. I assume YOU chose your surgeon, decided to proceed with surgery, and agreed with the choice of periareolar incisions. Probably also the implants chosen. Though you did not specify, let's assume your implants are identical. Any asymmetry you see now must be due to your pre-existing asymmetry, or residual swelling. At 5 months post-op, most swelling is resolved for most patients, so what you see is most likely your own pre-existing asymmetry (which is very common).

Implant choice (different sizes on each side) can indeed improve pre-existing asymmetry, but that is something that needs to be planned, discussed, and decided upon prior to surgery. Depending on the decision-making process, this is something that you and your surgeon should have discussed PRIOR to surgery--as in, "If I want bigger (or smaller) implant(s), who pays for what?"

As for periareolar incisions, at 5 months post-op your scars are not yet mature, and I would reserve judgement on both the scars and their effects on your areola shape and symmetry for 6-12 months (or at least until they have faded and softened maximally). Asking for more surgery and complete circular periareolar scars to "make them better" may simply give you more of what you don't like now. Your areolas were not significantly altered by use of incisions at the edge. But scars are permanent, and asking for more scarring ("nipple correction surgery") doesn't sound like a very good plan, regardless of who pays.

In my office, I would charge an operating room fee only, no surgeon's fee, and no anesthesia fee if the revision is done under local anesthesia (otherwise, you would also be responsible for anesthesia fees.) But first, take a deep breath, relax, and understand that your surgeon is on your side, not an adversary you need to blame to obtain "free" revision surgery. If more can and needs to be done, then you and your surgeon can talk about the options, possible outcomes, resultant scarring, and who pays for what. It's not "free" since nothing has been done "wrong." Best wishes! Dr. Tholen


Minneapolis Plastic Surgeon
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