Should I consider having a FNG done? (photos)

FNGs will not leave you with sensation of your nipples or areola. I think when patients think of a FNG they think of the exact same nipple areola complexes (NACs) they have now but just smaller and perfectly round in a new location after a graft, but that's not the usual outcome. Typically there is some loss of the areola and pigment changes and flattening of the nipple so one must think long and hard about undergoing a FNG. I left you a link to a video that you might find helpful.

It's completely understandable to feel anxious about your breast reduction surgery, especially when considering factors like nipple sensation, shape, and skin color changes. Whether or not you need a free nipple graft depends on several factors, including the amount of tissue to be removed and your surgeon’s technique.


First, I would not focus on "cup size" but perhaps a percentage of what you want removed per breast. I typically use the 50% as a reference to see if this is “too big, too small, or just right” for the patient’s expectations. Based on the photo, I would expect a reduction could be achieved without a free nipple graft and utilizing standard pedicle technique for breast reduction surgery.


Typically, a Free Nipple Graft is required in cases where a significant amount of tissue is removed, or if the nipple needs to be repositioned significantly higher on the breast. In these cases, the nipple is detached from the underlying tissue and reattached in a new location. However, this method can result in a loss of sensation in the nipple area, and the color and size of the nipples can also change. Since you expressed concerns about nipple sensation and appearance, this would be something important to discuss with your surgeon, who can guide you in selecting the best approach based on your goals.


On the other hand, a traditional breast reduction technique (such as the anchor or vertical incision method) typically allows for the preservation of nipple sensation, and the nipples are usually resized and repositioned but remain attached to the underlying tissue. This means the nipple can maintain its blood supply, sensation, and color.


To ensure you feel confident and comfortable with your decision, be sure to discuss all your concerns, including nipple symmetry, sensation, and color changes, so your surgeon can tailor the procedure to meet your aesthetic goals.


Best wishes,


Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained
Aesthetic Plastic Surgeon
New York, New York

It is true that your surgeon can be more aggressive in volume reduction with FNG, but your points are valid. I counsel patients that they will end up around a "C" cup with this operation generally speaking. Nipple sensation changes are always possible with this operation. Having said that, I think you will have a nice result and be very happy with a standard pedicle reduction mammmopalsty.