Can I have breast reduction without having my nipples reattached?

-The answer to your question is "yes," however, this is rarely performed because the overwhelming majority of women would like their nipples/areolas to look as normal as possible after their breast reductions. -I have had two patients, both quite a bit older than you, who had extreme breast ptosis (sagginess of the breasts) along with very large breasts, and these patients wanted their breasts to be very small AND they desired to not have free nipple grafts (whereby the nipples/areolas are removed and sewn back on in the appropriate position as skin grafts.)-They both did great, were happy with the outcome of their operations, consented to undergoing complete removal of their nipples/areolas, and did not miss this portion of their breasts postoperatively. -HOWEVER, this is uncommonly performed (less than .5% of my breast reduction practice) and breasts without nipples/areolas do look somewhat strange! -In 99% of breast reductions I perform, the nipples/areolas are moved to the appropriate position based on the blood supply from a superio-medially based pedicle. -I recommend you meet with a board certified plastic surgeon to discuss your concerns. Thanks for your question!

In most cases breast reduction is not done using the free nipple graft technique, so that removing it would be an extra step. On the other hand if your breasts are massive and this technique is required, then yes, you and direct your surgeon to not put your nipple/areolas back on. This would be an extremely rare decision even for those women that are not vain.

Women with large breasts have no nipple sensation because the nerves to the nipple have been stretched and do not conduct. There is a new technique called The Ultimate Breast Reduction, which lifts the breast to the normal position relieving the tension on the nerves. After this procedure, women who have numbness pre-operatively regain sensation. For this reason, I would not remove your nipples. The traditional technique (Wise pattern) leaves a boat anchor shaped incision and results in nipple numbness.

Best Wishes,

Gary Horndeski, M.D.

It is very uncommon to actually remove the nipple/areola and graft back on in a breast reduction, so the nipples are not removed in the first place. It isn't a vanity issue, it's more of a question of what is normal, and no nipples would be abnormal.

can certainly be done as long as you are absolutely certain you do not want the nipple complex anymore. Be prepared for a special consent but by giving up your nipple. you are actually making the procedure easier for your surgeon. If your current surgeon won't do it, believe me, there are many more who would accommodate your desires.

Usually when performing a breast reduction procedure the nipple and areola complex is kept on a leash of breast tissue called a pedicle. This usually maintains adequate blood supply for the nipple and areola to survive.

We try to leave the nipples attached. Only the VERY LARGEST breast reductions have the nipples "removed" as in free nipple grafts. Those need to be sewn back on. In general they are always left attached.

In almost all breast reductions the nipples are moved up but remain attached to the underlying tissue. Sensation usually (but not always) remains intact. I do recommend removing the nipple-areolar complex as a free skin graft in smokers who cannot stop smoking and need to have the nipples moved a significant distance.

The nipple is not "sewn back on" with a breast reduction, it is moved, but not detached from the breast. To completely remove the nipple during breast reduction and then replace it is a rarely used technique.