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Should I Need a Free Nipple Graft for Breast Reduction?

asked 9 months ago by K in MO in Missouri
Latest answer by Tom J. Pousti, MD
Question viewed 340 times
Tags: nipples, free, graft, opinion

I have had several consults in the area, hearing from all of them that I would most likely need a free nipple graft. I'm 29 years old so this isn't particularly appealing. lol Wear 38I/J bras, would like to be 38D but would do 38DD if it would avoid FNG. Measurements: Notch to Nipple: 38L, 37R Fold to Nipple: 17L, 16R Est tissue removal: 1800-2000g per side Do you have any advice? Agreement? Disagreement? Thanks.

12 answers to Should I Need a Free Nipple Graft for Breast Reduction?

+2

Free nipple graft for breast reduction is uncommonly indicated.

Most reductions can be done safely without a free nipple graft. In older patients where the nipple and areloa need to be transferred several inches, jeopardy to the viability of the areola might make a free nipple graft necessary. In my practice, this is only occasionally done (less than 1 in 50 cases).
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+2

Breast reduction without free nipple graft

Breast reduction can be done safely without a free nipple graft. I feel the technique is past its time. The grafted nipple will lose sensation, texture, and even lose some of the color and we have better solutions to preserve the nipple circulation, even with very large breast reductions. My advice would be to keep looking. Best of luck, peterejohnsonmd
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Free Nipple Grafting?

Thank you for the question. Although I understand your concern about the downsides of free nipple grafting at your age, sometimes this is necessary to avoid serious complications after the breast reduction procedures performed. If several well experienced board-certified plastic surgeons have suggested this procedure then it is likely that it will be in your best interest IF you decide to proceed with the breast reduction procedure understanding the... more
Tom J. Pousti, MD

San Diego Plastic Surgeon
+1

Free nipple grafting in breast reduction

In my practice, I rarely perform free nipple grafting for breast reduction. With free nipple graft, you will not have sensation to your nipples and will lose pigmetation on your areolas. In rare circumstances when we suspect blood supply to nipple-areolar complex is compromised, we perform free nipple grafting in order to avoid nipples "dying" after surgery. Given your measurement, I do think conventional breast reduction (without free nipple graft) can... more
Sugene Kim, MD

Houston Plastic Surgeon
+1

Free nipple graft with breast reduction

Hard to tell with out photos or an exam. Free nipple grafts are rare these days. Most can be addressed with moving the nipple areola complex on a pedal of tissue. Good to see several board certified plastic surgeons. Also would ask if they do many of these, and are they experienced with large reductions. Ask to see before and after photos. Also a good idea to bring in photos that you like. Together you will be able to make an informed decision. more
Jeffrey Roth, MD

Las Vegas Plastic Surgeon
+1

Free nipple graft

Hello, You are a bit on the large side for an inferior pedicle reduction but it can be done successfully. There are few women who absolutely "need" a free nipple graft technique these days Best Regards, John Di Saia MD
John P. Di Saia, MD

Orange Plastic Surgeon
+1

Breast Reduction without Free Nipple Graft

Yes, your surgery can be done without the free nipple graft. There are two parts to breast reduction surgery, the skin part and the pedicle. The pedicle is the tissue that remains after the excess is removed. It is the tissue that the nipple areolar complex gets its blood supply from. The predominant breast reduction method used by plastic surgeons is the "inferior pedicle" method. In this procedure breast tissue is removed from the inferomedial,... more
Christopher L. Hess, MD

Fairfax Plastic Surgeon
+1

Is Free Nipple Graft necessary?

I could not answer this question without seeing photos and examining you. I will only use nipple grafting technique about 2% of the time, but sometimes it may be necessary depending on a number of factors to prevent nipple or areolar wound healing problems or necrosis (skin death) . If several doctors have suggested that this would be the best procedure for you, it may be the case. If you don't ,you may have to accept the possibility of losing your nipple altogether. more
Marialyn Sardo, MD

La Jolla Plastic Surgeon

www.centerforbeauty.com

+1

Breast reduction without a free nipple graft

Dear K, The need for nipple grafts are a thing of the past. No longer do patients need to go through this unnecessary procedure to have large breasts reduced. Vertical scars are also not required to reduce or lift breasts that are large in size or have excess drooping. Best wishes, Dr. H
Gary M. Horndeski, MD

Houston Plastic Surgeon

www.horndeski.com

+1

Questions regarding the free nipple graft approach for breast reduction for gigantomastia

It appears that there is a significant consensus regarding your situation and the usage of a free nipple graft approach. At your young age, this is not as easy a decision to make versus being much older. Nevertheless, given your massive size (as stated though without the aid of photos), there is a very high risk of loss of tissue and of the nipple if other techniques are used, Other considerations are the shape that would eventuate from other techniques versus the free nipple graft... more
Steven Turkeltaub, MD

Scottsdale Plastic Surgeon

www.turkeltaub.com

+1

Needing a free nipple graft

My recommendation to you would be to follow the advice of multiple surgeons who have seen and examined you (and seem to be in agreement) rather than relying on advice from surgeons who have not seen even a picture, much less examined you. Your measurements and estimated tissue reduction size do seem to indicate that you are at risk of diminished blood supply to your nipples, but there is just no subsitution for an examination. (More than just the... more
Michelle Spring, MD

Marina Del Rey Plastic Surgeon
+1

When do you need a free nipple graft breast reduction?

The indications for a free nipple graft are few and far between and this is a rare form of breast reduction which is reserved for the patient in whom it is felt by the surgeon that based on their anatomy, the risk of nipple death from inadequate blood flow is too high to proceed with a conventional reduction. These patients are typically very large, very long, and often have very thin breasts making the blood flow to the nipple fragile in a reduction. Staying larger (no cup size... more
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

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