For optimal results in breast augmentation the breast tissue needs to be centered under the nipple which should lie about 20cm from the notch between the collar bones & the implant should be centered under both. A large number of women do not have breast tissue centered under the nipple or the nipple in the proper position even if they have never had breast surgery. In these patients some adjustment of the breast tissue is required prior to placing the implant. This can only be reliably performed through a nipple incision. Another problem is some women have breast tissue that is not centered under the nipple but this does not become apparent until after an implant is placed under the breast.

23 years old, 5'3" tall, 110 lb., 32B bra size
Smooth saline implants (400cc on the right and 375cc on the left) were placed under the muscle. In this case both nipples had to be moved closer to the midline during surgery. Adjustments also had to be made for difference in the positioning of the right and left ribs that make an exactly symmetric result unachievable.

Breast augmentation surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.