Breast Reduction Without Nipple Trauma Possible?

I am the lady with the 40I breasts! Even though I desperately need a reduction! The thought of having no sensation & reconstructed nipples is VERY upsetting! Why does there need to be such trauma to the breast, in particular the nipple? The whole procedure sounds almost like a mastectomy! I have seen some pictures where the breasts have very little scarring & others with Lots of scars and dips where the scar is (the lollipop). Do doctors insist on reconstructing areolas, or is it up to patient?

Doctor Answers 5

Areola reconstruction and nipple sensation

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The procedure involves removing a significant amount of tissue and ducts from the breasts, which is why there is trauma associated with the surgery. Areola reconstruction depends on the extent of correction desired and the result you'd like to achieve. It is not always necessary, but this depends on your goals. 

Some patients may notice a decrease in nipple sensation. This is often a temporary issue that resolves on its own, but can also be permanent.

Large Breast reduction without impairing nipple sensation

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See one or more experienced, board certified plastic surgeons if possible and get their recommendations on the type of procedure they would perform and the risks involved.  Many very large breasted women have had reductions without losing nipple sensation and with very satisfactory scars.  All surgeries have some risk and because of individual anatomy and many other factors it is impossible to guarantee that your nipple sensation will not be affected.  If the distance between the crease under the breast and the nipple is extremely long , there may be more of a risk of nipple loss--in that case a surgeon will recommend a free nipple graft which causes a loss of sensation.  Most women, however, are candidates for doing the procedure in a way that usually preserves some or all of the sensation.

Marialyn Sardo, MD
La Jolla Plastic Surgeon
4.0 out of 5 stars 6 reviews

Avoiding nipple trauma during breast reduction

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You are a 40 I.  I have reduced breasts as large a a M without injuring the nipple.  The technique is called the Ultimate Breast Reduction, which is based on the principle of breast weight transfer to the underlying muscle.  The breast is reduced and reshaped, nipple sensation is preserved and the ability to breast feed is maintained.  This technique avoids the vertical scarring of the llollipop or boat anchor incisions.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

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Nipple Trauma and Breast Reduction

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A breast reduction is not just a removal of the extra breast tissue but also a reshaping of the breast to achieve a more natural and aesthetic result.  Part of this reshaping process almost always requires that the nipple be elevated and re-positioned at the appropriate place for the new size of the breast after the reduction.  Most often this can be accomplished without having to remove the nipple from the breast and so the possibility of maintaining sensation exists.  However, if your breasts are too big and a free- nipple graft technique is required, then loss of sensation will also occur.

Remember, the primary goal during a reduction is reduce the size of the breast to what is appropriate for the patient's body and to obtain relief from the pain and symptoms of macromastia.  On a side note, many women also note that they have more sensation in their nipples after their reduction surgery than they did before.  I hope this helps you feel more comfortable and best of luck with your surgery.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.7 out of 5 stars 88 reviews

Can always get what you want

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A breast reduction includes reducing the breast size and lifting the breast.  The lifting part requires moving the nipple north and because of blood flow compromise in reducing a huge breast, it is possible to lose the nipple entirely and the sensation even if the nipple survives.  Not that the surgeons are trying to hurt the nipple, it is just simple anatomy.  You might also need a free nipple graft which will for sure make the nipples look somewhat odd and they will have no feeling.

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.