Nipples too high after breast reduction and lift? (Photo)

Question

October 2023 I had a breast reduction with a lift. It is now August 2024 and I have heard from my husband, friends and the bustmob community that my nipples are too high and my breasts are still substantial. I was looking forward to enjoying my body during the summer but every time I wore a swimsuit, my husband would say “babe, your nipples are showing”. So, I am sharing my before and after photo because I would like surgeons perspective.

Joel Patrick Maier, MD · Answer

Looks to me like you had a conservative amount of tissue removed. There is a substantial amount of volume in the lower aspect of your breasts that remains. I would recommend resection of more breast tissue to improve the breast proportions and with adequate removal, the nipples wound stay in the same location. It is very likely that your nipples may be in a relatively better position. Thank you.

Emre Guvercin, MD, FEBOPRAS · Answer

Based on your description and the timing (nearly a year post-op), what you’re experiencing is not uncommon &mdash; and no, this is not just a matter of opinion or styling.At this stage, swelling has resolved and the breast shape has stabilized. When nipples appear too high in swimsuits while the breasts still feel substantial, this usually indicates a combination of bottoming out and loss of upper-pole (first-pole) support. In other words, the breast tissue has dropped, while the nipples stayed where they were surgically placed &mdash; making them look high and overly exposed.This situation is often misunderstood as “nipples placed too high,” but anatomically, the nipples are usually in the correct position. The real issue is that the lower pole has lengthened, the breast mound has descended, and the upper pole has emptied. That’s why the breasts can still feel large yet look unbalanced.Can this improve on its own?At nearly one year post-op, spontaneous improvement is very unlikely. Exercises, bras, or time won’t correct this type of structural change.What is the best correction?You are a classic candidate for a revision Push-Up Lift.A revision Push-Up Lift focuses on:Correcting bottoming out by shortening the lower poleRepositioning your existing breast tissue upward and inwardRestoring upper-pole fullness without implantsImproving nipple orientation so they no longer appear too highCreating a more compact, lifted, and balanced breast shapeImportantly, this is not about making you smaller again, unless that’s part of your goal. It’s about rebuilding support and shape, which the initial surgery did not adequately maintain.Why implants are usually not neededIn cases like yours, implants would often worsen the problem by adding weight to already unsupported tissue. Most patients have enough natural tissue &mdash; it just needs to be repositioned correctly.*** Bottom lineYes, there is significant bottoming outYes, the upper pole is under-supportedThe nipples look high because the breast has dropped below themA revision Push-Up Lift is the most effective correctionThis can restore balance, confidence, and comfort in clothing and swimwearA consultation with a surgeon experienced in revision breast surgery and Push-Up Lift techniques would be the appropriate next step. This is a correctable problem &mdash; and you’re right to seek a professional perspective.

Krishna Vyas, MD, PhD, MHS · Answer

If you feel that the breasts are too large, you may qualify for another reduction, especially to resect more breast tissue from the lower part of the breast and improve the overall shape.

Your nipples may appear too high because the lower portion of the breast tissue hasn't been reduced enough. This could cause the breast mound to be disproportionately shaped, leaving the nipple in a higher position than desired.

It might be beneficial for you to seek a consultation with an experienced plastic surgeon specializing in breast surgery to discuss your potential options and see which approach would work best for you based on a thorough examination of your breast shape and tissue.

Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Aesthetic Plastic Surgeon
New York, New York

About Dr. Krishna Vyas, MD, PhD, MHS
Dr. Krishna Vyas, MD, PhD, MHS is a double-fellowship trained plastic surgeon specializing in aesthetic surgery and breast surgery. He has received advanced training from renowned institutions, including Harvard, Mayo Clinic, and Johns Hopkins. Dr. Vyas is widely regarded for his expertise in aesthetic breast and body surgery, including breast augmentation, reduction, lifts, and gender-affirming surgery (such as chest masculinization and feminization for transgender and non-binary individuals). Dr. Vyas is recognized for his expertise in breast and nipple sensory nerve preservation and restoration. His PhD in clinical and translational science focused on stem cell biology, fat grafting, and improving outcomes in aesthetic surgery, breast surgery, and regenerative medicine. He has authored over 200 peer-reviewed publications and presentations and serves on the editorial boards of multiple medical journals.

Recognized for his expertise, Dr. Vyas was appointed an Instructor of Surgery at Mayo Clinic and served as an Assistant in Surgery at Harvard Medical School and Massachusetts General Hospital. At Mayo Clinic, he embraced the core value of "the needs of the patient come first," contributing to its status as one of the best hospitals worldwide. Dr. Vyas has served in leadership roles, including as President of the Mayo Clinic Fellows Association, Board of Directors for the Mayo Clinic Alumni Association, Chair of the Mayo Clinic Young Investigators Research Symposium, and Board Member of the Graduate Medical Education Committee.

A dedicated mentor, Dr. Vyas has guided hundreds of aspiring medical students and professionals, shaping the next generation of surgeons and researchers. His contributions to the field have earned him recognition as a Kentucky Colonel. As an innovative leader in aesthetic surgery, breast surgery, and gender-affirming surgery, Dr. Vyas continues to make a significant impact through his surgical expertise, research, and unwavering commitment to patient-centered care.

Kayla Humenansky, DO · Answer

Hi cori_cakes23, High nipples following a breast reduction can be challenging to change. There are general recommendations for breast measurements. The two most commonly used measurements include the sternal notch (the indentation where your collar bones connect at the center of you neck) to nipple distance and the distance from the nipple to the inframammary fold (crease beneath your breast). In your photos, the distance from your NAC-IMF (nipple to fold) distance appears quite large. I would speak with a board-certified plastic surgeon about their thoughts regarding an inferior wedge resection. This would remove tissue from the lower pole of the breast and help pull the nipple lower on the breast mound. Other alternatives to changing the position of the nipple when it is too high include skin grafting or advancement flaps.

Ajaya Kashyap, MD · Answer

Thank you for your query. This is a phenomenon called “bottoming out” of the breasts , where most of the breast tissues move downwards and the nipples stay up. The way to correct this is further reduction of the tissue at the bottom of the breast and to convert the technique to a Wise pattern breast reduction. Please discuss your concerns with your Plastic surgeon who should be able to help. All the best!

Daniel Barrett, MD · Answer

Dear cori_cakes23,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

I’m not sure if your nipples are too high or if they look that way because the lower portion of the breast is stretched out. The lower portion of the breast needs to be tightened up by removing more skin and breast tissues to give you a better result

Karl William Schwarz, MD · Answer

It is tough to lower a nipple but in your case the distance from your nipple to your infra-mammary fold (breast crease) is long so in order to get a better shape to your breast that tissue would have to be removed which fortunately would also lower your nipple.

SO essentially you would have another breast reduction with the same scar pattern but your breasts would be less heavy and have a better shape and your nipple would be in a better position.

Camille Cash, MD · Answer

Based on your photos it appears you would benefit from a revision.  Your nipple placement is high and the distance between your fold and your nipple is too long.  This can be improved from a revision to your lift.  If you still feel your breasts are too large, further reduction can be performed as well.

Oliver Harley, FRCSEd(Plast) · Answer

Thanks for this interesting question

Its difficult to say for sure but i think the nipples are positioned about right  - approximate landmarks for nipple level are:  1.  underbreast fold; 2. mid-humerus - half-way between shoulder and elbow if you stand in relaxed posture with arms by your sides. 3. ballpark 20 cm measured from the notch at the front of your neck (at the top of your sternum between collarbones) to each nipple.

looks to me as though the lower pole of breast has filled out / stretched or maybe was not reduced sufficiently at surgery.  usually we would aim for this distance to be 7-10 cm - myy guess is that if you get a tapemeasure and measure the curve from nipple to underbreastfold, you may have nearly 15cm here.

so the nipples look porportioantely high because the lowerpole is too long/big and maybe when you are in a bikini/bra, the lower pole breast tissue pushes the nipples up and over the top of the bra-cup.....

i would suggest a 'melonslice' reduction - where a melonslice of skin and breast tissue is removed from the lower zone of the breast to leave approx 8 cm of distance between nipple and the lower curve where it joins the underbreast fold.

best regards to you

oliver harley FRCSEd plastic surgeon

Nipples too high after breast reduction and lift? (Photo)

Answers (12)

More Breast Reduction Questions

Reduction in May 2023, my nipples have been ruined. Correction options? (photos)

Age 79, is it possible to get a breast reduction if I have a pacemaker?

Possibility of permanent numbness from breast lipo & how long would temporary numbness last?

I had a breast reduction 13 months ago and it's smaller than I wanted. Can this be fixed? (Photo)

Am I a good candidate for a breast reduction?

Sutures left behind - would it be possible to revise this again? (Photo)

WE SEND PRETTY
EMAILS