Can augmentation help with high areola placement?

Question

Previously 36DD, now about one cup smaller. Please advise whether breast augmentation would make my areola placement “appear” in a more ideal (lower) position? Or would repositioning the areola be the only other option or shortening the vertical scar? Symmetry is fine; however when I wear some types of bras my nipples are literally spilling over the top. I am not keen on having larger breasts again, but now I am insecure.

Ronald J. Edelson, MD · Answer

Your breast lift looks excellent. I don't think your nipples are too high but they look that way because if some bottoming out. That can be corrected at the same time you get implants in. A lift is a great procedure but it's hard to get upper fullness without an implant.

Gary M. Horndeski, MD · Answer

At size 36 D and you do not want large breasts again then implants should not be placed. You will need a revision of the scars. The inframammary scars can be redone and reshaped them to pull the nipple-areola complex lower to a more normal position.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Scott W. Vann, MD, FACS · Answer

Your nipples are a little high but your vertical scar is too long for sure. I think you could have a very nice result by shorting the vertical scar by and placing a modest implant centrally located behind the nipple  location. This would give you a rounder shape and upper pole fullness. Good luck.

Vasileios Vasilakis, MD, FACS · Answer

Thank you for the question. Based on your photos, your nipples are a little too high compared to the entire breast. Placing implants will likely make it worse as they will further fill out the lower poles. I wish you the best of luck. Vasileios Vasilakis, MD. Fellowship-trained plastic surgeon. Houston, TX.

Donald R. Revis Jr, MD · Answer

Good morning,
Yes an implant would rotate your nipple position inferiorly and better center them on your breasts, but you could also, with or without augmentation, revise your crease scar yo shorten the vertical limb.

Daniel Barrett, MD · Answer

Dear Exquisite684429,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. If you had radiation that can cause an overall tightening and lifting of the breast and areola, but an examination in person by a board certified plastic surgeon would be required to properly evaluate you and advise you on your options. I would recommend starting with your original plastic surgeon if this is a possibility.

From your photos it appears that the vertical length of your lower pole (distance from nipple to fold) has lengthened over time. This is called “bottoming out” or “pseudoptosis”, and when the areola peaks out from the bra or bathing suit top it is referred to as a “sunset deformity”.

The treatment is generally to remove skin from the lower pole thus restoring a better proportion with perhaps slight lowering of the nipple areola. From your photos it does not appear that your areolae need to be relocated.

If the main problem is certain bras, find bras that work better for you. Best of luck to you.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Unfortunately most implants are going to only worsen the appearance by increasing the lower breast skin stretch.  The best option would be a revision of the breast lift.

Joshua B. Hyman, MD · Answer

The breast implant will not change the position of the nipple. I would recommend getting a small revision lift at the time of breast augmentation to make sure you have the perfect shape.

Darryl J. Blinski, MD · Answer

My opinion is round 1: redo inferior breast lift. round 2: Implants in the 350-400 cc ranges. Total fees $20,000+.Seek in person or virtual opinions.

Can augmentation help with high areola placement?

Answers (11)

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