What is the Optimum Distance from Collar Bone to Nipple?

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.

Thank you for your question. There are some women who will benefit from adding a breast lift to a breast augmentation. In general, if your nipple is located at or above the crease below your breast then a lift is typically not needed. In addition to nipple position, measurements are also used to determine when to add a lift. It's important to know the breast implants do not lift the nipple to any significant degree, so you can't escape the lift by using a breast implant. Breast sagging is a spectrum and women with mild/moderate sagging can sometimes go either way. In this situation, I typically recommend breast augmentation as an initial procedure, waiting six months, and then only performing a breast lift if it is truly needed. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide which procedures are right for you. 

The normal range from sternal notch to nipple for a fully developed woman with well positioned breasts is anywhere from 16 to perhaps 26+ centimeters. Regarding your individual needs, a full examination will be necessary to determine the best option(s) for you. Implant alone vs lift alone vs implant plus lift are the 3 typical options with many different approaches including the 3 usual lift scars; circumareolar (circular), vertical (lollipop) and anchor or ("inverted T").The SN to N distance alone is not sufficient to make the exact determination of which procedure is best.

A variety of measurements are utilized to determine the
proper nipple areola position. The
distance between the sternal notch and nipple is frequently used to help with
the determination. Although this
measurement is helpful, it’s not an absolute predictor of proper nipple
position.This number varies with the
height of the patient and typically ranges between 18 and 23 cm. The
best guideline for nipple areola position is probably the relationship between
the nipple areola complex and the infra-mammary fold.In an aesthetically attractive breast, the
inferior areola should lie above this fold. It’s
important to understand that multiple factors determine proper nipple position
when breast lift surgery is performed.This determination not only requires scientific measurements but
artistry as well.

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.

various measurements can be used for best position.  18-21 cm from clavicle to nipple is one number


you can measure from the sternal notch

you can look at the mid point of the upper arm

you can measure a projection from the inframammary fold

I agree that this measurement has little value in determining the need for a lift.  The shape of your breast, the position of the nipple relative to the breast fold, and the amount of breast tissue that descends below the breast fold when standing all help determine the need for a lift.  There really is no way to know for sure without seeing you in person or evaluating photos of your breast.  There certainly are situations where you could choose to do either a lift or just an augmentation if the amount of sag is moderate.  This may explain why you have gotten different opinions.

Thank you for your question.It is very common to get a different plan from different surgeons as each has different experience for which procedures work best in their hands.  The ideal nipple position is described in different ways as there is no one “measurement” that fits for everyone.The ideal nipple position should be at the most projecting part of the breast, in the middle of the breast, equal distance from the midline, and slightly above the inframammary fold.  Other guides would be vertically at the mid humeral line (halfway between shoulder and elbow). From a measurement standpoint an average measurement might be 21 cm from sternal notch to nipple and 10.5 cm from the midline. This forms an equilateral triangle.  This does not account for differences in patient height and chest dimensions.  In my practice I typically used a combination of all of these to discuss when a lift might be necessary.Dr. L

I do not recommend that youmake a decision based on just this number alone.  I do recommend that you see a Board Certified Plastic Surgeon to work with you and evaluate your measurements, and optimize your chances for your best possible results.  Multiple measurements will be taken including breast base width, skin laxity, and much more in a full consultation and evaluation/planning session for you.

There are certainly variations in the “Optimal Distance.” Some women have small torsos and others have large torsos and some  have wide chests or narrow chests. Most commonly, I use the nipple to sternal notch distance as a good baseline. I formulate a “breast triangle”. The two sides of the triangle are from the right nipple to sternal notch and the left nipple to sternal notch. The base of the triangle is measured from the left nipple to the right nipple. Often, a measurement from the nipple to sternal notch is 21centimeters and this seems to be a baseline measurement. Also, the mid-humeral distance is helpful, which is the distance from the shoulder to the elbow. Another helpful measurement is the measurement from the bottom of the areola to the inframammary fold. Numbers are helpful but ultimately the best breast is one that is a best fit for your body. I insist on in-depth dialogue with my patients  to discuss what your specific cosmetic goals are and it is then my task to help you achieve those goals.