What If the Nipple Is Too High After Breast Reduction?

Breast reduction surgery

reduces size while also

lifting the position of the drooping

nipple.

Generally speaking,

because this is a procedure done

to improve sagging, it is easy to think

that the higher the nipple position,

the better.

However, an excessively high nipple position

is not only unattractive in terms of

the overall breast shape,

but can also lead to the nipple protruding

out of bras or bikinis,

causing a great deal of inconvenience

in daily life.

In fact, nipples that end up positioned

too high do not usually appear immediately

after surgery.

As time passes,

the nipple position often seems

to gradually rise.

Having the nipple corrected too low

after surgery can also be a problem,

but a nipple positioned too high

is also a side effect of

breast reduction surgery.

So where on the breast

should the nipple ideally be located?

When the whole breast is divided

into upper and lower halves,

the nipple is best positioned

slightly below the center.

Any medical team performing breast reduction

takes this into account when planning

the preoperative design, so it is rare

for the nipple to be positioned high

immediately after surgery.

However, the reason this problem occurs

is often not a mistake in the preoperative design,

but rather because enough tissue

from the lower part of the breast

was not sufficiently removed during surgery.

As the sagging of the heavy lower breast tissue

progresses, a pattern of pseudoptosis appears,

with the nipple remaining in the same place,

and as a result the nipple appears

relatively high.

This is called a high-riding nipple

in English.

There are roughly three ways to improve

this high-riding nipple.

First, the most commonly used method

is to remove the excess tissue in the lower area.

While removing the drooping lower portion,

the inframammary fold is raised by about 1–2 cm,

which helps rebalance the nipple position.

However, this method does not directly lower

the nipple position.

It is merely a kind of camouflage tactic,

where the lower tissue is removed so that

the nipple appears to be located more centrally

on the breast.

Therefore, if the absolute nipple position is high,

that is, if the distance from the upper center

of the sternum to the nipple is shortened to

less than 18 cm, it is difficult to expect

great results.

In such cases, the nipple is actually lowered

by using techniques such as a V-Y flap

or a transposition flap from the upper skin

around the elevated nipple.

Unfortunately, this method has the downside

of leaving a long, unsightly scar

on the relatively visible upper part of the breast.

The third way to correct a high nipple position

is to insert an implant or fat into the breast.

If an implant is placed mainly in the upper breast,

or if fat grafting is performed to fill the upper volume,

the starting point of the upper breast rises,

making the nipple appear relatively more centered.

In addition, the skin on the upper breast

stretches slightly, which has the effect

of lowering the nipple position.

So far, we have looked at the so-called

high-riding nipple and the treatment process

when the nipple position is too high

after breast reduction surgery.

In fact, when the nipple is this high,

treatment becomes quite difficult,

so rather than correcting it later after it occurs,

it is important to prevent it in advance.

If you discuss the design in detail with the

surgeon right before the reduction surgery,

I hope you will achieve a result without

this unfortunate side effect.