I'm 24 years. 40.k I recently had a consultation. The surgeon tells me that my only option is the free nipple procedure (Photo)

If i lose weight and my size decreaaes would i more options? Possibly the pedicle technique? I have asked around a few people that have had reductions with the nipple graft technique. I get mixed reviews. One coworker of mine got hers done 20 years ago with breast twice my size and she says that she has erogenous senation in both of her nipples. I want to see an expert . I need a second opinion.

Doctor Answers 9

I'm 24 years. 40.k I recently had a consultation. The surgeon tells me that my only option is the free nipple procedure

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I have not done a free nipple graft in over 10 years in cases like yours. Unless there are other circumstances, an attached nipple may be possible.

Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Is my only option a free nipple graft in breast reduction?

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From your pictures,  and your young age, I think you could safely undergo a conventional breast reduction with preservation of the nipples, but sensation would be uncertain, and it would require to you to have a fairly large breast. A free nipple graft gives more flexibility in shape size, and perkiness.  I would suggest seeking more than one opinion. An in person consultation really is necessary.

Free Nipple Graft?

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Thank you very much for your question.

Part of the equation on whether or not to do a free nipple graft is how much smaller you want your breasts to be.  In order to prevent a free nipple graft, you would need a fairly large/long pedicle (area of tissue) to ensure adequate blood supply to support the nipples.  Therefore, your breasts would need to remain on the larger side (but still smaller than what you have, and more lifted).

If you wanted to go much, much smaller, then the pedicle with the blood supply to the nipple wouldn't be big enough, and your nipples could die from poor bloody supply.  The reason to do the free nipple graft is so that you can remove a large amount of breast tissue, and not worry about the blood supply to the nipple.

I think it's a good idea to get a second opinion if you aren't comfortable with the first recommendation.  Best of luck!

Daniel Krochmal, MD
Chicago General Surgeon

My only option is the free nipple procedure.

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Though many might recommend a reduction with a free nipple graft, you are not limited to this procedure alone, and it is possible to complete a breast reduction and preserve the nipple and sensation. You are right in looking for another opinion and options.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast reduction

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 From your photographs, I can see why the surgeon you saw wants to do a free nipple graft. weight loss will not affect this ratio of length to width of your breasts to any great degree. There are ways of making a small pedicle at the bottom which doesn't involve blood supply to the nipple that can add projection to a free nipple grafted breast. It is the lack of projection that makes this operation have a bad outcome as well as the lack of nipple sensation. Even with a pedicle, with that length, no one can promise that the nipple will have sensation anyway. I recommend you see a board-certified plastic surgeon with experience in breast reduction surgery. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Candidate for a BR

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Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a breast reduction.

Also known as reduction mammoplasty, this is an operation intended to reduce the size of a woman’s breasts and improve their shape and position. Frequently, the areola (dark skin around the nipple) is also made smaller. Functional symptoms (medical disorders) caused by excessive breast weight may be relieved or improved by this operation.
Women who have large, heavy breasts, which may be the cause of movement difficulties, back, shoulder and neck pain, poor posture, bra-strap indentations and chafing under the breasts will benefit from reduction.
Women with excessive breast size, which may decrease a sense of attractiveness and self-confidence, are candidates.
Large breasts that interfere with normal daily activities or with exercise will be more comfortable when reduced.

Lower BMI will help

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A lower BMI will help.
The breast length is very long, so I understand your plastic surgeons concerns.
You can also seek some other opinions in your area.
Best wishes.

Breast reduction and free nipple procedure...

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Based on your photographs, it is clear that you will be an excellent candidate for breast reduction surgery. Also, based on the size/positioning of your breasts and the nipple/areola complexes, free nipple grafting  is likely a good recommendation. If you undergo this procedure, do not expect to have any sensation of the nipple/areola complexes, regardless of what your friends say.

In general, if you are able to lose weight prior to surgery you will be better off when it comes to the safety of the procedure as well as the quality/longevity of the long-term outcome.

Select your plastic surgeon carefully. Working together you will come up with the best plan (and timing) to achieve your goals safely. Best wishes.

Free Nipple Graft

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Thank you for your picture.  Based on your picture you would be a candidate for a free nipple graft.  Weight loss would not give you more options concerning a breast reduction. I stopped performing free nipple grafts in patients with large long breasts.  I use a different technique to preserve nipple aesthetics.  See video link above.

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.