My nipples are too high after breast augmentation with lift
I had a breast augmentation with a lift last year, and for the most part I like how they look now. The one thing that I don’t like is how high my nipples sit on my breasts now. It sounds like this can sometimes happen. What do I need to do if I want them repositioned?
Some patients are concerned to find the position of their nipples too high after a breast augmentation or lift. While elevated nipples are associated with a more youthful position on the breast, the nipples can sometimes be located too high on the upper pole of the breast.
For a woman of average frame, the distance from collarbone to nipples is usually in the range of 18 to 21 cm. If the nipples are closer to the collarbone than this, patients may notice that their nipples show when wearing bras, low cut shirts or bathing suits. This is understandably disappointing when you were hoping to have a natural look following your breast surgery.
There are several reasons why your nipples may be too high. The most common being that the breast implant position is too low, or the implants have migrated down the breast pocket. In this case, the breasts are referred to as being bottomed out. As a result, the nipples are displaced into an upwards and slightly outwards location on the breast mound, thus appearing overly elevated or "stargazing", and more likely to pop out of clothing.
The distance from the nipple to the breast crease is also another determining factor in the position of the nipples. On average, the distance between the nipple areola complex and the inframammary fold should be approximately 6-9cm. If it is longer than this, there is an increased chance that the implants may settle too low in relation to the position of the nipples. Another possible cause for high nipples is that during the lift portion of the surgical procedure, the nipples were repositioned excessively high up the chest wall and too close to the collar bone.
In some cases, plastic surgery does not result in the post op outcome you were hoping for. It is important that you communicate your dissatisfaction to your plastic surgeon so you can explore why this may have happened and formulate a plan to treat the issue. There may be an easy fix, or better, you may even find that once any remaining swelling from surgery subsides, your nipples will settle into position and appear less prominent.
However, some high nipples require surgical revision, and unfortunately, are not always easy to correct surgically. In certain cases, correction can be extremely challenging, requiring the skills and expertise of a board-certified plastic surgeon who has extensive experience performing nipple areola revision procedures.
One revision surgery that can be effective involves raising the height of the infra-mammary fold and breast implant pocket by carrying out a capsulorrhaphy. For other individuals, the distance between the nipple and breast crease needs to be shortened, which requires the resectioning of skin along the breast crease. If you book a consultation with a plastic surgeon, he or she will be able to look at the specifics of your case, determine the cause of your high nipples and make the appropriate recommendations to correct the issue.
This may be due to the nipples sitting high (if they were "overcorrected" in the lift) or the implants riding low (in which case the position of the nipples is proper with respect to other landmarks but they look high with respect to the implant position). It is very hard to lower nipples because it would leave a scar above the areola, whereas raising is easier (the scars remain around and below the areola). A set of photos could help us review options with you better.
-- Dr. Sayed
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Tim Sayed has 4 Breast augmentation (Saline breast implants), Breast lift, Extended abdominoplasty before & afters: