Is a free nipple graft really necessary?

i am a 4'11 24 year old woman who has yet to have children. Is There a way for me to achieve the breast i want with out the FNG i would rather take that route. Measurements: I am around a 40L and a 36O US. My N2N - R is about 40 cm L is about 30 cm. My F2N - R is about 18 cm and L is about 20 cm. I am hoping for a medium C to a small D as my results. What do you think?

Doctor Answers 7

Free nipple graft

Hello and thanks for your question-
It sounds like your breasts are disproportionately large and you'll probably feel much better after reduction.

It's not possible to make a definite surgical recommendation online, especially without seeing photos. While some surgeons have specific cut-off measurements for certain breast reduction techniques, I need to examine each patient in person before I make a recommendation. I personally do not like the free nipple graft technique, as it looks less natural, takes longer to heal, and eliminates breastfeeding and nipple sensation. I think a carefully planned pedicle technique can be done on most women, and there are several pedicles (ways of keeping the nipple attached) that can be done.

My advice would be to get several opinions before you schedule surgery, especially if free nipple graft is all that has been offered to you so far. There may be several different techniques that could be good options for you.

Best wishes-

Banff Plastic Surgeon
5.0 out of 5 stars 27 reviews

Is a free nipple graft really necessary?

In the majority of cases, free nipple grafts during breast reduction surgery is not necessary. An in person consultation with your local plastic surgeons will be the best way to determine if this technique would be required. Thank you for sharing your question. Best wishes.

Dr. Gregory Park

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

Is a free nipple graft really necessary?

Thank you for your question.  I've performed many breast reductions over the years and never had to do a free nipple graft.  From my personal perspective, I don't think they're necessary.  I would only use them if I determine that the nipple areola viability and blood suppy is not good.  I would not commit to them ahead of time.

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Free nipple graft breast reduction

It is impossible with an online consultation to give you accurate advice regarding the need for a free nipple graft.  In a typical breast reduction, the nipple is left attached to some breast tissue, which is called the pedicle.  The pedicle needs to deliver adequate blood flow to the nipple to keep it alive.  The longer and larger the breast, the more difficult it is for the blood flow to make it to the nipple and the higher the risk of partial or complete nipple loss.  Additionally, the longer and larger the breast, the bulkier the pedicle is making it more difficult to achieve a small-sized breast, which a C cup would likely be for you.

A free nipple graft has several disadvantages including lack of sensation, a flatter appearance than most nipples, loss of pigmentation (this usually improves with time), and the inability to breast feed.  While none of these trade-offs are ideal, they may be worth it to achieve your desired breast size.  Even if you were able to have a breast reduction without a FNG, there is still a risk that you won't be able to breast feed when you have children.  Of course, if breast feeding is your main concern, the safest option would be to delay your breast reduction until you're done having children.

I suggest you see another plastic surgeon for a consultation.  If they also agree that a FNG is the safest option to achieve your desired breast size, then you will have to make the decision whether the trade-offs are worth it to you.

Lisa J. Peters, MD
Chicago Plastic Surgeon
4.8 out of 5 stars 12 reviews

Free Nipple Graft?

Based on your measurements and without benefit of photos a free nipple graft should at least be considered especially on the right.  That said, in a young woman contemplating beast feeding every effort should be made to preserve the nipple/areola attachments.
Best of luck.

James L. Moore, MD
Athens Plastic Surgeon
5.0 out of 5 stars 2 reviews

Is a free nipple graft really necessary?

Some surgeons feel free nipple grafting is a "safe" means for breast reduction. We have never used the technique and after hundreds of breast reduction procedures we do not believe free nipple grafting is necessary. 

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Is a free nipple graft really necessary?

Despite providing us with measurements,  online consultants will not be of much help when it comes to providing you with specific advice.  If in doubt, I would suggest that you meet with a few well experienced board-certified plastic surgeons who can demonstrate significant  experience achieving the types of outcomes you'll be pleased with.  If you receive a consensus about the need for free nipple grafting, it will likely be your best interests to proceed in this fashion.  Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 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.