Reduction in May 2023, my nipples have been ruined. Correction options? (photos)

Thank you for your query. The pulling in and deformity of the nipples is because of scar tissue. The scar tissue can be released and autologous fat grafting can improve the look of your nipples significantly. Some liposuction on the sides will help with the “side rolls”. Rather than sagging of your breasts there is some “bottoming out” going on , the tissues moving down while the nipple-areola stay up. This can be corrected only by a revision of the procedure using a different technique. Please discuss your concerns with your Plastic surgeon who can help you or with another Plastic surgeon who is more experienced with these procedures. All the best!

Dear lish6902,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Your areolae can be reshaped pretty easily. The main issue is that your have too much skin and breast tissue in the lower portion of the breast. L. That is also a straightforward correction to have done

Thanks for your question! If you are bothered by the recurrence of droop, you could always consider another lift. That could also help with the nipple deformity by getting the nipple/areola centered on a more projecting part of the breast. Good luck!

It appears the nipple has contracted laterally. This may benefit from release or possibly areola revision. If you compress your breasts inferiorly, this will allow the nipples to achieve a normal position.

Best Wishes,

Gary Horndeski, M.D.

I don't think your nipples are ruined--what is happening is they are being pulled towards the outside of the breast because they are attached to the underlying tissue (pedicle) and that is falling down and out and taking the nipple and areola with it. It can be fixed by redoing the reduction and sewing the pedicle to the medial aspect of the chest and reducing the size of the pedicle to get rid of the weight. Obviously this would mean another surgery but it might be worth considering or at least discussing it with your surgeon. He is the best person to do this as he did the first surgery and knows where the blood supply to the nipple and areola are so it is also the safest way to do it.

As for the roll--it was there before but not in the same configuration and that's what has changed by lifting the breast the roll has just become more prominent but it is pretty normal so I wouldn't concentrate on revising it.

From the posted photos it appears you would benefit from a revision to the lift. This would include correction of the nipples and a nice improvement is very possible. If you are no longer confident in your surgeon, visit with another board certified plastic surgeon in your area for a consultation.

Your nipples are not "ruined." More tissue can be removed, especially from the inferior scar to give a better size and shape and help fill in the area behind the nipples. Liposuction on the lateral chest will help correct the rolls.

To make a quality assessment regarding a plastic surgery outcome we need to see proper before and after pictures. If you don’t have before pictures then ask your surgeon to forward the pictures they took.
It looks like you had divergent breasts and your surgeon attempted to bring the nipple position more medically(words the midline) in doing so the nipples are being pulled laterally (towards the side) cause your outcome.
The lateral dog ear(skin fold on the side) is common especially if the surgeon limits the length of the scar. Sagging is common after a breast reduction. The nipple position is usually improved but the breast shape is often somewhat flat.
Best,
Mats Hagström MD