Breast Augmentation: Cost, Reviews, Photos

Correcting high nipples placement

Assuming that your nipples were not high to begin with, it might be that your implants are sitting too low.

This can be corrected by using two or three layers of sutures inside of the breast implant pocket to re-build the crease under your breast to a higher placement.

The result of this should be an elevation of the implants higher on the chest and a rotation of your nipples into a more central area on the breast mound.

It is possible to decrease the diameter of your areola at the same time. (Edwin C. Pound, III, MD, Atlanta Plastic Surgeon)

No easy solution to high areola showing above clothing

Unfortunately there is no easy solution to this problem. If the areola is too high, there is one way to lower it.

That is to put in a tissue expander and expand the skin above the areola. The extra skin can then be used to lower the position of the areola.

Patients do not want this procedure as the tissue expander is very obvious, cannot be disguised and is quite strange looking. The best solution is to select your clothes and bras carefully.

Repositioning the implants can change the relationship of the nipple to the breast mound but will not address the issue of the areola skin being visible above your clothing. I am sorry there is no other excellent solution. (Tracy Pfeifer, MD, Manhattan Plastic Surgeon)

Not easy to correct overly elevated nipples

An overly elevated nipple/areola after breast lift surgery with or without implants is not uncommon and can be related to placing the nipple/areola to high and to the inevitability of descent / “bottoming out” of the breast with time due to gravity and tissue stretching.

The nipple/areola position cannot be lowered effectively, but the lower breast can be repositioned higher on the chest wall to improve the balance such that the nipple/areola is better centered at or near the central portion and apex of the breast mound, rather than well above the center as can occur with time.

Unfortunately, despite these efforts to revise the breast, the same problem can occur again. (David J. Levens, MD, Coral Springs Plastic Surgeon)

High nipples placement after breast augmentation and lift

There are two reasons why nipple position can look high after breast augmentation and lift. First, and fortunately less common, the nipple was actually placed too high when the lift was performed. If this is the case, the nipple has to be lowered, and you will have a vertical scar above the nipple (where it was lowered from). The other cause, which is more common, is that the distance from the nipple to your breast fold is too long and the nipple is not at the center of the implant. This is called a “high-riding” nipple and can be corrected by repositioning the implant higher and reducing the distance from the nipple to the breast fold. Unfortunately, both cases are technically challenging. See the video below for more on breast lifts. (Michael A. Jazayeri, MD, Santa Ana Plastic Surgeon)

This can be better addressed with a photograph – having said that, if there is too much skin between the nipple-areola and the fold under the breast, this can be corrected by removing a segment of skin from the lower pole breast area or repositioning the implants higher or both. (J. Vicente P. Poblete, MD, Cleveland Plastic Surgeon)

If your implants have settled too much, this will make your nipples appear to be too high on your breast mounds. This can be improved by repositioning your implants by adjusting the implant pockets.

If your implants are appropriately positioned on your chest wall, then usually the height of the nipples can be reduced by excising some skin in the inframammary creases (the creases below the breasts).

This reduces the distance from the creases to the bottom of the areolae and helps center the nipple/areola complexes more appropriately on the breast mounds. It is possible that you already have scars in these areas from your prior lift.

Your plastic surgeon can discuss options with you after he or she has examined you. (Michael D. Yates, MD, Huntsville Plastic Surgeon)

Nipple placement after a breast lift

It is always easier to lift or raise your nipples, but lowering them without leaving a scar above them is a difficult problem. There are generally few solutions to the problem you describe of having your nipple too high after a breast lift or breast reduction, and none of them are an easy fix.

The three options that are available is to have a scar above your nipple after you move it down, something that would show in low cut shirts, but it would not have a dark pigment like your nipple does.

The second option is to raise the implant which will artificially lower the nipple. And the third option, which is much more aggressive and rarely done is to place tissue expanders and stretch the skin above your nipples. If you have any further questions, you can always shcedule a consultation at our office. (Ankit Desai, MD, Jacksonville Plastic Surgeon)

Too high breast nipples placement can usually be easily fixed

Yes, this usually can be corrected without the vertical scar above your breast nipples. But, it depends on your current breast shape and implant position.

I have corrected this for several women who have complained of similar issues. It all depends on your current breast shape and measurements.

I’d be happy to look at some pictures and give you an opinion. You can also check out my photogallery page on Breast Implant Revision.

The third woman on the page complained of a similar problem. (Daniel P. Markmann, MD, Baltimore Plastic Surgeon)

We try to avoid this at all costs, because it is so much easier to raise the breast nipples a little more after a breast lift with breast implants, than to lower them.

Placement the implants higher can make the nipples look lower. Otherwise, lowering the breast nipples leaves a vertical scar above them. Tough problem, I am sorry to say. (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)

Malpositioned breast nipples

This is a difficult situation, as it is not easy to lower them. However, one thing that may help would be to remove some of the skin along the horizontal scars. You may also need to go with a smaller implant as well. (Scott E. Kasden, MD, Dallas Plastic Surgeon)

Elevated breast nipples after augmentation and lift

This is so difficult to asses without an examination, but if the placement of breast nipples is not too high, this can be addressed either by moving the areolae down slightly, or by repositioning the implants.

The procedure which would be more appropriate for you depends on your examination. I would recommend seeing a board-certified surgeon for evaluation and possible revision. (Nina S. Naidu, MD, FACS, New York Plastic Surgeon)

Since it has been a few years after the surgery, the situation is stable. The position of the implant ideally is dead center behind / under the location of the breast nipples. If the implants sag, the breast nipples assume a higher “star gazing” position; It the implants are placed too high OR the patient develops scarring around the implants which raises them the nipples will appear low.

There are several ways of dealing with high nipples which would depend on the reason. A sagging implant can be raised by repairing and tightening the implant pocket.

Otherwise, a scar would have to be placed on the breast above the areola/nipple to lower it and or the breast fold would have to be relocated. These are challenging situations. (Peter A. Aldea, MD, Memphis Plastic Surgeon)

High riding breast nipples

Treatment options would vary based on the specific findings on examination. Based on what you describe it truly depends on the size of the implants and the amount of skin beneath the areola. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

The answer depends on how high the breast nipples / areolas actually are. If they are slightly high, they can probably be lowered with a number of simple options depending on what type of lift you had. If they are way too high, more drastic measures may be needed, ranging from additional incisions, moving the implant, etc. A face to face consultation is important to make this decision. (David Shuter, MD, Jupiter Plastic Surgeon)

Breasts Too High After Augmentation

It’s difficult to predict how the high breast implants will settle, but it’s important to remember that implants tend to ride high initially and will descend over the course of six weeks to three months.

Sometimes high breast implants will descend over the course of six months. I think that it’s too early to tell whether a revision will be required. Consultation with your surgeon will help answer your questions as you work through this process.

Many surgeons will have patients were a bra with a built in elastic strap that is secured over the top of the breasts. This holds the implants down during the healing process. (Austin Hayes, MD, Portland Plastic Surgeon)

When patients undergo breast augmentation the implants are high t first. The submuscular pocket allows for this. It is temporary and the implants will come down with time, massage and use of a supportive bra. (Frank J. Ferraro, MD, Paramus Plastic Surgeon)

High implants after augmentation

You do appear high for a textured implant. I typically place the textured implants lower than a smooth implant because they tend to settle a little less. Breast implants can fall dramatically so unfortunately the only answer is to wait and see. (Pramit Malhotra, MD, Ann Arbor Plastic Surgeon)

At 3 weeks after surgery, you are so early after surgery that there is really no reason to worry. It appears from the markings that the surgeon created the pocket to have the appropriate lower pole fullness. If in fact they opened the pocket the way it is marked, the implants should fall nicely into position. I do not think a revision is necessary before the implants are allowed to fall, which can take 6 months. (Gary Lawton, MD, FACS, San Antonio Plastic Surgeon)

Implants Positioned Very High

Implants always sit a little higher than planned after augmentation due to tightness of the overlying soft tissues (muscle, breast gland and skin) and swelling. With time as these structures relax and swelling subsides, the implants generally descend into the pocket as long as it was made large enough with enough release along the origin of the muscle.

Smooth implants are more likely to drop more quickly than textured implants, which “lock” onto the surrounding soft tissue. You should consult with your plastic surgeon about whether a breast strap is indicated and you should be followed regularly to see if the high breast implants are settling into the pocket as planned. (Scott A. Brenman, MD, FACS, Philadelphia Plastic Surgeon)

Breasts Too High?

It is not uncommon for implants to be unnaturally high initially and it can take 3-6 months for then to descend. By your photos they do appear high and you may want to express your concerns to your surgeon. Typically one would initiate displacement massages to help lower the implants – this can be tougher to do if there is a textured Siltex covering. In general one would wait a minimum of six months before considering revision. (George Volpe, MD, Boston Plastic Surgeon)

How long to wait for implants that are too high?

At 3 weeks, it can be difficult to tell where the implants are going to settle. It’s definitely too early to worry too much about it. I would advise you to see your plastic surgeon. He/she will be able to tell if non-operative intervention might be able to help the implants move into the appropriate position. (Dustin L. Reid, MD, Austin Plastic Surgeon)

Textured implants do not tend to fall into position with time like smooth round implants do. I do not usually instruct patients to massage textured implants as it is unlikely they will drop into position. If your situation persists, contact your surgeon and ask him how long to wait for the high breast implants to drop. In most cases the implant is in place by about 6 weeks, but may take even longer.

I would think at 3 months he would be talking to you about potentially repositioning the implants or exchanging your device. (Stephen J. Vega, MD, Rochester Plastic Surgeon)