American Society of Plastic Surgeons
For Medical Professionals
3 months ago

Where do I start

I had a breast aug and lift in April 2021.

I started noticing my nipples were way too high at my 1 mo post op. I knew it was too soon and I had to wait for them to settle. By my 3 mo appt, I brought it up and was told it was still too soon. By my 6 mo appt, I was told they “saw what I meant” and would consult the md and get back to me. Didn’t happen. Now I’m here and want to see where do I start?

Procedure: Breast Lift
Location: Los Angeles, CA

Replies 6

Carlos Quintero
ASPS Int. Surgeon

Hi, a good way to determine if the nipples are higher than expected, is to measure the distance from the mid portion of the clavicle bone to the nippe, with a measuring tape ( for example), the aesthetics of this distance is 19-21 cms.

If you measure this distance in both breast and they fit into this measure, then your nipples are located in the best aesthetic location ( this is what I think from seeing your pictures).

The distance from the lower portion of the areola to the inframamary fold seems to be elongated, this gives the optical illusion that the nipples are too high.

This is a frequent situation after breast reduction/lift/augmentation, is directly related to the effects of the weight and gravity in the breast tissue and implants.

Shana Kalaria
ASPS Surgeon

You have some bottoming-out where the implant is falling below the intended position causing a long vertical incision and nipples to appear to be facing upwards and too high. This can be fixed with revision surgery. Please visit with a board-certified plastic surgeon with experience in revision surgery. Good luck!

Nora Menendez
ASPS Int. Surgeon

Hello, if you have not yet contacted the doctor who operated on you, that would be ideal. In any case, there is a solution and you are in time to a revision surgery, with your same doctor (ideally) or if it is not possible, choose a certified and experienced surgeon.

Alfred Antonetti
ASPS Surgeon

Your nipples are not too high. You had quite a bit of breast tissue and ptosis to stat with. You had a mastopexy with implants on top of your already big enough breasts. You had ptosis to start because your tissues do not have enough elasticity. The weight of the implants causes more stretching and what is called "bottoming out". This is not uncommon with this type of operations. It can be revised by closing the lower pocket and shortening the areola to fold distance. For the best result, it may take the use of a mesh. If your surgeon was an ABPS certified plastic surgeon you need to call the office and make an appointment to see the doctor and not one of the representatives. Keep calling until you have the appointment. If you still can not make this appointment you need to see another ABPS certified or eligible plastic surgeon close to your home.

Norman Bakshandeh
ASPS Surgeon

Your nipples are high. This can be easily fixed with revisional surgery which can be easily done.

Rahul Vemula
ASPS Surgeon
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Thank you for your post. Just based on these pictures, your nipples do not look too high on your chest. What is going on here is you have a condition called bottoming out where the implant is sitting low on the chest and much lower than where it should ideally be.

This is a greater risk of happening when an augmentation, and a breast lift are combined and when a larger implant is used.

You would benefit from a revision surgery, please visit with a Board Certified Plastic Surgeon for all of your options


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