Considering a silicone breast implant with lateral nipples

Dear Dr. Reed,

Am considering 400 cc silicone. Your thoughts?


Dear Veronica,

It is not unusual for the male chest to have more laterality of the nipple areola complex (NAC).  For a female to have them off to the side doesn’t look quite right.  The easy way to handle this is to choose a relatively wide implant, certainly not one that goes under your armpit.  This will give more of the impression that you NAC is more centralized.  Imagine if you wanted a smaller based one and of course want the implants together to show cleavage.  This will certainly leave the NAC off to the side..

When considering implants remember silicones require a larger incision.  Salines are inserted empty and an incision slightly wider than the base of your pinky will do.  For MTF’s we favor placement unde the muscle, sub-pectoral to give more coverage than just your home-grown.  Once under the muscle it is difficult to discern whether it is saline or silicone.  Salines also have the advantage of being adjusted to the nearest volumetric amount to look balanced.  Silcones are made in sizes 25 to 50 cc apart.

Still having said this, we find many of our patients are very insistent on silicone.  Beauty is in the eye and the hand of the beholder.

Harold M. Reed, M.D.



2 Responses to Considering a silicone breast implant with lateral nipples

  1. I have breast inmalpts and I went over the muscle with a smooth saline filled bag. I am not sure what you mean when you say you can feel the edges but I can feel my bag at times> Very normal but wouldnt hurt to check with your doctor. Was this answer helpful?

    • Dear Sasha,

      I don’t recommend as a rule implants over the muscle for that reason especuically in transsexuals where the may not be sufficient home grown breast mass to cover the implant. Please understand sub-pectoral implants are called dual-plane in that the lower outer border (let’s say 20%) is not completely covered by the muscle, but IMHO better than no coverage at all.

      Harold M. Reed, M.D.
      The Reed Centre for Transgender Surgery – Miami

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