There's a lot I can deal with for the relief of a Breast reduction with a free nipple graft: loss of feeling, no erotic sensation, inability to breastfeed, scars, pigmentation loss, etc. However, it really bothers me that I may end up with permanently flat nipples. It's very hard to let this little piece of my womanhood go. Are the results of a free graft nipple always a flat unnatural appearance? Is there anything I can have done to have a erect or semi-erect nipple?
Flat Nipples: Anything Can Do to Have a Erect or Semi-erect Nipple?
Doctor Answers 3
Flat Nipples after Breast Reduction?
Thank you for the question.
You are correct in that there are many advantages to having breast reduction surgery for most patients with symptomatic breast hypertrophy. You may be surprised, despite having free nipple grafting, about the projection of the nipple that remains postoperatively. If you are dissatisfied with the projection/length of the nipple afterwards, grafting of dermis or cartilage may be helpful.
Flat nipples after free nipple graft
You might be surprised that there will be some nipple projection after a free nipple graft. The nipples will definitely lose some volume, but not necessarily so much that augmentation will be required.
First, you have to heal. I wouldn't recommend any revisional surgery until all the wounds and swelling are substantially healed. This will probably be a year. Then, assess nipple size. If you fell that extra volume will make you happy, it is fairly easy to add a small gravt under the remaining nipple to give it additional projection. Usually local anesthesia only is required.
Possible graft of fillers
If your nipples were to heal flatter than you like after your reduction with free nipple graft, you might consider discussing with your plastic surgeon the use of something to give them more fullness. Some options might be (once you have appropriately healed) a cartilage or fat graft or possibly injection a filler such as Juvederm, Radiess, etc. Discuss these options with your plastic surgeon.