Can I get nipple repositioning after a breast augmentation?

Had silicone breast implants put in 3 months ago and now my nipples sit too high on my chest. I don’t think I was anticipating this and now I want to know how soon after surgery I can consider having a nipple repositioning procedure? Can I do it next month or is it recommended to wait longer to make sure my implants fully settle?

Willartt

F, 37, Pennsylvania

It's not clear from your question that nipple surgery is what's required. Low nipples following a breast augmentation are frequently a sign of "bottoming out". When implants bottom out, they shift lower within the pocket, slipping beneath the natural inframammary fold under the breasts. This downward shift causes the nipples to appear "too high" on the breasts.

Breast implants can shift lower for a variety of reasons, and even the best plastic surgeons occasionally face this issue. The pocket may have been over-dissected -- or overly large implants may cause them to drop lower.

Without a direct examination I can't make any direct recommendations, but from your question it sounds like you may need revision surgery to correct the pocket, which is something you should discuss with your cosmetic surgeon.

There are several surgical options that can address this issue. Your surgeon can use sutures and skin flaps to shift the breast higher on the chest and better center the nipples. You may also benefit from a breast lift / mastopexy to raise the breasts and remove excess tissue.

However, if you are considering nipple repositioning you should consider that surgery to move the nipples will result in some scarring around the areolas. Typically, the earliest a nipple repositioning surgery should be considered is approximately three months after your prior breast surgery.

Dr. Landon Pryor has 2 Breast augmentation before & afters:

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I'm sorry to hear that you're unhappy with the results of your breast augmentation. In my experience, a nipple position that is too high after new breast implants is most likely a result of implants that are positioned too low on the chest.

While I can't make a specific recommendation without a direct consultation, it sounds like the implants may have moved below your inframammary crease. While nipple repositioning is possible, I would advise proceeding with caution if following this approach. Moving a high riding nipple lower is a challenging procedure which will almost certainly leave scarring near the areola and may decrease nipple sensation.

I would suggest communicating this issue directly with your plastic surgeon and discussing the possibility of a revision surgery to revise the pocket. By raising the position of the implants on the chest the nipples will shift lower on the breast mound.

Dr. Jonathan Heistein has 2 Breast augmentation before & afters:

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We usually request that patients wait at least six months before considering any type of revision surgery. I would recommend a visit with your surgeon to discuss what your options are and whether your nipples are sitting too high, if you've bottomed out, or if the pocket needs to be adjusted. 

Dr. Robert N. Young has 1 Breast augmentation before & after:

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I would let the implants settle fully before having another surgery.  Although your implants may be settled by this point, you can't be sure that they won't still continue to change a little.  Discuss your concerns with your surgeon, and he/she will help you come up with an appropriate timeline.  Best of luck!

Dr. Jonathan Heistein has 2 Breast augmentation before & afters:

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Dear Willart, 

The problem is almost certainly not your nipple position but your implant position. Nipples that were properly positioned before simply do not become "too high" on the chest after breast augmentation unless the implants are too low. I would bet the farm that your implants are too low, a condition called "bottoming out", which will make the nipples look unnaturally high. One of two things happened. Your surgeon either consciously or unknowingly lowered your natural inframammary crease (the curving line where your breast meets your chest wall) too far, or you implants migrated inferiorly too much over the 3 months. It is critical to diagnose the problem correctly to plan the right corrective measure. If the implant is too low, the pocket must be revised to raise the crease back to its normal position. This is not easy to do. If you truly have nipples that are too high, a very uncommon condition by-the-way, this is also very difficult to fix and will leave scars around your areolae. Do not let anyone operate on your breasts who does not explain to you very clearly, and in a manner that makes sense, what they are planning to do and why. Even experienced, board-certified plastic surgeons will have the occasional patient who bottoms out. If your surgeon fits this description, go back to him or her immediately and let them know you are having this problem. If your surgeon was anything other than a board-certified plastic surgeon and/or if you have reasons to question their skills or practice, then run and find yourself a good surgeon to fix this. Again, I bet your problem is not your nipples but your implants. 

Sincerely, 

R. Bosshardt, MD, FACS

Tavares, FL 

Yes you can but I would wait 3 months until the breasts have completely settled in position.

Dr. Donald Kress has 9 Breast Augmentation before & afters:

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