Does T anchor top surgery for FTM reduce nipple sensation?

I'm a FTM (female to male), and I'm looking into top surgery. I want to keep my nipple sensation but I am unable to find any info on the particular type of surgery I want done. I am looking at T anchor surgery (inverted T method) since my cup size is Almost a D cup. So it falls on the larger side of breast sizes. Does reduce breast tissue effect the nipple in a big way? If so why? Are people get hypersensitive nipples or hyposensitive nipples?

Doctor Answers 5

Nipple Sensation and TOP Surgery

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.


Dr. Dadvand

Los Angeles Plastic Surgeon
4.9 out of 5 stars 39 reviews

Does T anchor top surgery for FTM reduce nipple sensation?

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.  

Josef Hadeed, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 9 reviews

Does T anchor top surgery for FTM reduce nipple sensation? #nipple sensation #top surgery

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!

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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.  

TOP surgery will cause nipple numbness

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.

Sheldon Lincenberg, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.