The nipple is usually positioned flat between the 4th and 5th ribs, but this positioning is usually used for men or women with small breasts. In women with large breasts, the breasts may be sagging and the positioning may not be as accurate, and may be flat between the 5th and 6th ribs. Also, in older women, the breasts are completely loose and very saggy, and the positioning is grossly inaccurate. It is possible that in older women the nipple usually sags as far as the 9th or 10th intercostal space, so generally if the nipple is to be used for localization, it is usually done by men or women with smaller breasts.