Does T anchor top surgery for FTM reduce nipple sensation?

If you have an inverted T operation with a D cup breast you may have nipple sensation, but you will still have breasts.  The correct approach to create a pec contour is DIM.  Even though there is no scientific explanation, most of the patients develop some nipple sensation.  

There are several methods used which depend upon the patient’s breast or chest #size before surgery. Considerations include the #laxity of skin, the #size of the #areola, the amount of #fat and recent weight #gain or weight #loss. The most common procedures which are described include the #periareola, #buttonhole, #double incision, and #anchor patterns. I often use #liposuction along with the double #incision for larger breasts, and, some variation for smaller breasts; depending upon the position of the areola. The female breast nipple and areola are often centered on the breast. However, the nipple and areola are lower and closer to the outside edge of the #pectoralis muscle in the male patient. Shaping the side of the chest may also be required and can be performed with #suctioning; along with contouring of the muscle, as noted above, to provide the best definition for the chest. Being each person varies, it’s important to be realistic about your goals and what is achievable. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Thank you for your question!  The T anchor approach for top surgery for female to male transgender patients is an attempt to preserve nipple sensation while reducing the size of the breast.  That being said, residual breast tissue is present and can lead to the appearance of a breast reduction rather than flattening the breast as much as the patient would like.  In essence, the result is a breast reduction appearance rather than removal of breast tissue which can be problematic and require further surgery to remove more breast tissue with the potential for nipple loss.  So, since you have a large cup size breast, the preferred method of top surgery would be removal of all the breast tissue with a free nipple graft.  This assures your chest appearance is as flat and masculine as possible.   One also needs to take into account your body dimensions.  For example, if you have large breasts and a small chest and a flat tummy the T anchor type of chest surgery may reveal too much breast tissue and a breast reduction result.  This type of patient body habitus requires removal of breast tissue with a free nipple graft. Contrary, if you have a larger tummy, a T anchor type of surgery may result in a flatter chest with some more prominence making you look more muscular with your T-shirt on.I would review the options with your surgeon and asked to see before and after photos and bring up the points that I mentioned in this answer.  I hope this helps!

A T anchor incision is commonly used for a breast reduction.  Although this technique will preserve nipple sensation, it will not provide a very masculine contour to the chest.  The best method for larger breast sizes is a double incision mastectomy with free nipple grafting.  

Hi Kirreya,Thanks for the post. The inverted T method will increase the likelihood of retaining sensation. This is because the nipple will be left attached to breast tissue (referred to as a pedicle). The downside to this is that keeping some breast tissue to maintain blood supply and nerve supply to the nipple will come at the expense of contour. You will still have breasts although they will be smaller. This is a common technique in female breast reduction. For D cup breasts, making the chest look masculine is better done with a double incision procedure with free nipple graft. I have seen my patients retain some sensation after this technique. Sincerely,Dr. Dadvand

The sensory nerve fibers to the nipple run through the breast tissue that is directly under the nipple. In most forms of TOP surgery, including the form needed to remove large breasts, the breast tissue removal contains those nerves and therefore there are no nerves connected to the nipple skin when the procedure is completed.