Breast lift with inverted nipple repair

All surgical procedures carry some degree of risk. Any breast
operation can result in changes in sensation. This happens less with lifts than
reductions but is still possible. Occasionally, minor complications occur and
do not affect the surgical outcome. Major complications associated with this
procedure are rare. The suitability of the breast lift procedure and specific
risks may be determined during your consultation. Given your healthy description the potential for complications would likely be minimal, but again discuss this with your PS. You can also remember that #hypertrophic or #keloid scars can be a problem. The worst are usually under the breast with
an #AnchorLift or inverted “T”. These
can be treated like all thickened scars with re-excision, laser, kenalog/5-FU
injections, creams, silicone strips and other methods to reduce and improve
healing. Best of luck!

Your plastic surgeon will be able to discuss with you the risks that you face if you perform a combined surgery such as this. All surgery has some risk and you must carefully weigh the benefits. You will need to ask yourself if there is a worst case scenario that happens to you, what would be outcome be and is it worth it. In my practice, I separate these two procedures. Often the breast lift can be performed first. Repair of an inverted nipple can often be performed at a later time under local anesthesia as an office-based surgery.

One of the major risks of breast lift, with or without augmentation, and breast reduction is areola/nipple tissue loss. The risk would depend on how much undermining or movement of the nipple areola was being done. With an inverted-T, with more than 4 cm of movement, the breast tissue has to be released quite a lot to move the areola upwards. I would personally not want to do both together, but perhaps other surgeons with more experience in doing them together would not find it a problem. Also there are different techniques, some cannot be done on women who want to breast feed in the future. When preserving the ability to breast feed, I would use pedicled flaps that go under the areola for support and that might increase the risk of problems with circulation, if it was borderline to begin with. 

Much of surgery is about minimizing risk. In particular, breast lift surgery depends on maximizing blood flow to assure the best healing. The nipple and areola are usually at the area of least blood flow. Therefore, I prefer to do the inverted nipple repair after about six weeks of healing. This can usually be done in the office with a minimum of discomfort to the patient.

I would also perform the inverted nipple repair at a later date to avoid any additional risk of healing problems including loss of circulation to the nipple.  I would wait about three months.

Yes this can be done together and it depends on your surgeon's experience and handling of the tissues. There's a higher risk of skin loss if there's too much tension with the anchor lift. You can always have the inverted nipple repair done later under local anesthesia and the risk is lower. Good luck.

There are so many variables here... that it is difficult to comment objectively.  However, if you had minimal elevation of the areola and was having the simplest technique of nipple eversion, it would be deemed safe.  If you were having a more complex eversion and bigger lift, it may be more prudent to do the eversion procedure at a later date once you have healed from your lift.  Let your surgeon know of your concerns so your surgeon can reassure you that it is indeed safe.

Dear MonkeyReg1984,Both procedures have a small risk of nipple necrosis.The risk is somewhat additive when the procedures are performed together because each puts the nipple under some circulatory stress.Having said this, it's not surprising that some surgeons feel that it is safe to perform both procedures together, and others don't.The overall risk, which is difficult to quantify, depends on a number of factors including your anatomy, your overall health, the surgical technique used, and luck.It is prudent to follow the guidance of your plastic surgeon, as the two of you are responsible for your care.Warmest wishes,Larry Fan, MD

I am personally more comfortable doing the inverted nipploe repair at another time, about 3 months after the lift. It is easily done with a couple of shots of local anesthetic and is a very easy recovery. You may well do fine when it is all done at once, but I see no point in taking a chance when the risk can be easily and totally eliminated by staging the operations.

Of course you need to follow the advice of your plastic surgeon. If you are uncomfortable I suggest that you get a second opinion with an in person consultation with another board certified plastic surgeon.Personnally I would be concerned about doing the nipple repair at the same time as a breast lift as blood supply to the nipple is already stressed by the lift.