After several consultations for breast augmentation, I have been given a different solution by each surgeon; ranging from breast aug. w/ asymetry correction (no lift) to full anchor lift with aug. I am not concerned w/ scarring but want a youthful shape. That being said, I don't want to endure unnecessary incisions if a good result can be achieved w/o a lift. Is there an optimum distance between collar bone and nipple? Can I use this measurement to help decide which plan is best for me?
What is the Optimum Distance from Collar Bone to Nipple?
Doctor Answers 18
Measurements for breast lift
The optimal distance from collar bone to nipple varies according to your height and chest width. Various ways to determine optimal nipple position include: 1. the aesthetic breast triangle...distance from sternal notch to L nipple, sternal notch to R nipple, and distance between nipples...all being the same number, 2. 1/2 the humeral distance from shoulder to elbow, 3. Just above the IMF along the breast meridian, 4. In the center of the breast mound. All of these ways can be used to help determine optimal nipple position. I hope this helps.
Breast shape and nipple position more important than specific numbers
Photos would be helpful to at least discuss the relevant possibilities for your particular situation. Without them and an examination, answers can only be conjecture.
Fixed distances to be used for determining whether or not a lift should be done is inexact and inappropriate as there is such variability despite the common belief that the normal distance is 18 - 21 inches. What is more important is the shape of your breasts, laxity of skin, and nipple position.
You may need to seek a few more consultations with reputable board certified plastic surgeons.
Breast Lifting Needed?
Thank you for the question.
The “ideal” distance from the sternal notch to nipple averages 21 cm.
Be careful that you do not rely on this measurement alone to determine whether you will benefit from breast lifting surgery. The relationship of the nipple/areola to inframammary fold ( best viewed from the side) it is of critical importance. Also, the presence of “loose” skin may point towards the need for breast lifting surgery.
It would probably be in your best interest to identify a well experienced board-certified plastic surgeon who you have confidence in and ask for his/her advice. This confidence is very important given that you will receive different pieces of advice from different surgeons ( all of whom have different experience levels etc.).
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Indications For a Breast Lift With Augmentation
The distance between your nipples and the top of your chest (suprasternal nothch) should be somewhere around 21cm and in an equalateral triangle. However nipple position is not the only factor in deciding whether a lift would give you the optimum shape. If you have a lot of extra skin or a breast gland that falls below the fold at the base of the breast a lift may be needed so that the skin envelope is a good match for the implant size you have chosen. Larger implants can raise nipple position a little bit, but are not a good choice to replace a needed lift. The fact that you have been given differrent opinions means that there is no one way to address your request. Have a thorough conversation with your surgeon so that you understand your choices. You might consider a two stage process where the implants are placed first and a lift decided upon after the implants settle.
Augmentation and/or lift
I would have to say that the standard ideals of old were measurements in books of 18-21 cms are probably not accurate. Often if nipples are lifted to those heights, they look too high. It really depends upon yoru body habitus and how the breast and nipple areola sit as compared to where your breast fold is.
Optimal Distance from Collar Bone to Nipple
One common measurement that is mentioned is the distance from the sternal notch (indentation above the breast bone) to the nipples - which is commonly 19 to 23 cm. However, this is a guideline and it does not apply to all patients. Each patients individual proportions need to be considered when considering the best option for breast surgery.
Nipple to collar bone measurement is not useful
The distance from the collar bone or the notch at the top of the sternum in the middle of your neck is not useful at all in my opinion in deciding whether to do a lift or not. The entire need for a lift is based on the relationship of the nipple and the lowest point of the inframammary crease below the breast. If the nipples have drifted down to near, at or below the crease or are pointing down, a lift is positively indicated. Implants won't lift you either.
Some ladies creases are farther down the chest wall than others and that is why the imporatnt relationship is crease to nipple, not nipple to collar bone. Some terrible mistakes have been made by using the collar bone to nipple distance as, if the creases are very low, the nipples can be way to high if you stick with using a notch to nipple distance for where they should be.
The Optimal Position of the nipple is halfway between the shoulder and the elbow
Youthful breasts are high on the chest wall. The ideal position for the nipple is halfway between the shoulder and the elbow. If the breasts are hanging, most likely you will need a breast lift. There is a new technique called the "Ultimate Breat lift" which does not require vertical scars or the traditional wise pattern. There is no single optimal distance from the collar bone to the nipple.
Best of luck,
Gary M. Horndeski, M.D.
There is no simple answer to your question because it is a proportions that we are really dealing with. This is a relative distances and the best look in regard to a nipple on a thorax depends on your height, obviously, but also on where the breast mound is located on the chest and also on what is pleasing to your eye and the surgeon's eye. There is no way to begin to answer this question for you specifically without an examination and consultatiion, but some basic ideas could be available based on good quality medical photos.
If nipples are lower than the folds under your breasts, you definitely need a breast lift.
Very hard to generalize without detailed exam, but that is a good rule of thumb. Distance from notch between your collar bones to nipples varies more with height and frame, but it should not be more than 23 centimeters.