Uneven Nipples After Breast Augmentation and Lift

I recently had breast lift and implants (200 cc, 1 cup size bigger, age 26 no kids) 2 weeks ago, and my nipples look like something out of a child's coloring book. They're completely uneven, choppy, and not at all near perfectly circular. Will these eventually fix themselves? I also thought the breasts would be higher. Does this look like a well executed lift?

Doctor Answers 93

Yes, you are uneven. But you are far from seeing your FINAL result.

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Like most of my colleagues, I am going to ask you to relax and let things heal before rendering final judgement on your plastic surgeon's work. Your mastopexy augmentation looks very well done, by the way.
Let's address your concerns as listed. First, uneven nipples. The irregularity around the suture line is due to the sutures, and as they dissolve and the tissues heal and the scars mature, this will settle to a degree that is quite good for most patients (everyone IS different, as are their scars). The skill of your surgeon and the fineness of the sutures and closure technique DO play a role in this. The skill of the surgeon also has a role in the roundness of the areola (how the cut is made), and whether or not the nipple remains in the center. This can easily be redone if it's "off" when healing is complete in 3-6 months, and when the scars have fully matured, softened, and faded in 6-12 (rarely longer) months.

BTW, did you or your surgeon measure your nipple position pre-operatively? I can virtually guarantee that they didn't match exactly before, so don't be too surprised that they may not match perfectly now. This is NORMAL!

Higher would seem, at least by your photos, to be unnatural. Did you mean larger, less full in the lower pole of your breasts, or did you  really want your nipple areola complexes closer to your collarbones? Measure your nipple-to-collarbone distance. Depending on your height, 19-21cm is considered near "ideal." Some of us adjust these figures a bit for individual anatomic differences, so this is not written in stone!

The bottom line here is: be patient, trust your surgeon, and listen to his/her advice. This appears to be a nicely-done operation that will likely be just fine when all is said and done. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Need time to allow the breats to achieve their final shape

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Your lift looks fine for one week post surgery. Symmetry is the curse of plastic surgery. If you only had one breast then there would be nothing to compare it to. Prior to a breast lift careful measurements are made in an attempt to achieve symmetry and a nice result. The fact is that despite performing the exact same procedure on each side the two breast will heal at different rates. One side will always drop faster, have less bruising and hurt less. In time things will even up. In the event of some degree of minor asymmetry a simple revision is all that is needed to achieve the desired result. Relax and give it time.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Nipples Uneven After Surgery

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The good news is that it is really much too soon to judge the final appearance of your results, including the size, shape and position of your nipples.

The "bad" news is it will take some time (months) to allow enough healing to judge if all is well or if some adjustments are desirable.

For now, discuss your concerns with your surgeon and try your best to hang in while healing progresses.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Breast Asymmetry

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Yes, you are asymmetric and yes you can be corrected if need be.  When I do combination breast augmentation/Mastopexy, I will allow three months to pass before any reasonable assessment can be done.  This will allow enough time for your soft tissue to settle and allow your skin to relax.  If after that time you still notice asymmetry a corrective surgery can be safely performed.  Remember of all the cosmetic surgeries we perform this particular on  augmentation/Mastopexy has one of the highest rates of correction.  I wish you well.

Uneven Nipples after Lift and Augmentation

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I concur. It is really too early to early to judge. Your photo looks pretty reasonable for just two weeks post-op. The nipples usually look somwhat artificial early on. Also nipples are not perfectly circular and perfectly even in anybody in real life and you should not expect them to be that way after surgery..................As speaker after speaker stated at the most recent ASPS meeting, Augmentation/Mastopexy is one of the MOST difficult operations we do. Many surgeons do them in two stages because it is difficult to get very good consistent results in a single stage operation. Why? Because the operations work against one another. When doing a lift you are trying to tighten and lift the tissues, while an implant works to expand the tissues, hence doing both at the same time tends to limit the benefits of each.

Time and realistic expectations needed for breast augmentation and lift results

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I would give more time for the breast to settle down. It already looks pretty good but few things wil change in the next few weeks or so. Give it time and do not stress out about it. Plastic Surgery is a science and art. 100% results simply do not exist. Best of luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Recovery from breast (any) surgery

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Dear Ajonesca, So far so good! Recovery from any surgery is always different in appearance in the first few weeks after surgery. Your surgeon will know best how things are coming along- as planned or not. From you photo things look like they are progressing well. The details you are pointing out are excellent and you are very astute as to the result you would like. You will know better by the 3 to 4 month mark. Follow up with your surgeon and haiving your questions answered will help you understand and be more comfortable with the recovery process.

Good Luck,

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

This is a great result. Breast lifts will settle. Breasts are never even.

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As a surgeon, my advice is that I believe you have an excellent result. Tissues are elastic and the shape cannot be absolutely predicted despite the best of surgeon's efforts.

IF you were made of clay, we could guarantee you a perfectly even result. We would use a mold and your results would never change. But your are not made of clay, your breasts are complex combinations of skin, fat, mammary parencyhma, firbrous tissues, skeletal frameworks, etc. When we build houses they settle. Initially smooth walls develop nail pops, foundations and drywall settle creating cracks and shifting of walls. Just as a building settles, so will your breast.

Your breasts are big for 200 cc implants, so it is my educated guess you had large breasts to begin with. At your age they will likely age (meaning more sagging) with time especially if you should have children and nurse.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Looks good, not perfect

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You are obviously recently post op. Overall the size, shape and symmetry of the breasts looks very nice. I agree that the left nipple is lower than the right, but I feel that the shape of the areolas looks nice. This is a very difficult operation to get a nice result, and you have a very nice result. It will get better as the wounds mature.

The nipples may or may not even out over time. If not, you may ask your doctor to raise the left one (difficult to lower a high nipple). This is fairly involved, and you must ask yourself if you are willing to undergo a significant revisional surgery to correct a small asymmetry. I would also suggest that you review your preop photos.


Areolas are swollen early on.

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All areolas are swollen early on and it will take a couple of months for all the swelling to disappear. Please remember that areolas are not perfectly circular in any woman. They have a slightly irregular shape with pigment fading out from them.

From the photo, it looks like the breasts have a good shape and the nipples are in good position. I am not sure what you mean by having the breasts be higher. The upper portion of your breast would be right under the collar bone and the nipples could not be placed that high.

Just because you can take your breasts and push them up higher with your hands does not mean that they can be surgically held there. I did not have the benefit of seeing your pictures before surgery, but, the postop pictures look excellent for 2 weeks.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.