Is the Nipple Always Removed During Nipple Surgery?

Is the nipple always removed completely from the breast before being reattached?

Doctor Answers 13

Removal of nipple

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Most surgeries on the breast do not change the nipple itself. If you want an actual reduction of the nipple, this can be done without removing the nipple. Only for very large breast reductions may the areolae (flatter brown tissue surrounding the nipple) be removed and then sewn back on as a graft. This grafting, however, is the exception and not the normal procedure for breast reductions.

San Antonio Plastic Surgeon
4.8 out of 5 stars 18 reviews

Is nipple removed during surgery?

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Are you asking about nipple surgery, such as nipple reduction, or breast surgery such as reduction or lift? For nipple reduction surgery, it is not removed. In cases of very large reductions, it is sometimes removed and replaced as a graft. This is usually not necessary. For breast lift operations it is not removed. Your plastic surgeon can advise you, if considering reduction, as to whether or not you would need a free nipple graft.

Hope this helps.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

The nipple is RARELY if ever removed during Breast Reduction surgery

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The Nipple is NEVER removed during nipple surgery (such as correction of inverted nipples).

In older techniques of Breast Reduction or Lift, when the sagging nipples where located a long distance from the mid line chest notch, it was thought by some that their blood supply was poor and rather than risk losing them, as the breast was lifted, it would be better to re-attach them as "free" grafts. This is rarely done these days except in truly massive breasts reductions when the nipples have no sensation already.

I really would NOT worry about this.

Peter A. Aldea, MD
Memphis Plastic Surgeon

The nipple is almost never removed in a lift or reduction

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Only in exceptionally rare cases is a "free nipple graft" performed in a reduction or a lift. The nipple and areola almost always stay on the breast tissue as it is reduced, moved up and re-shaped.  Not to worry! 

Nipples rarely removed during nipple surgery

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Rarely is the nipple completely removed from the breast in most plastic surgery. What kind of surgery were you exploring? An older technique of breast reduction did involve nipple removal and replacement, but it is rarely used these days.

John P. Di Saia, MD
Orange Plastic Surgeon

Nipples Not Removed for Most Nipple Surgery

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The nipple is rarely removed for most nipple surgery. Further details, your photographs, and  an examination  would be required for the best advice.

Nipples are almost always left attached to the breast during surgery

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In any surgery of the breast where the breast tissue is being arranged (breast reduction) or the nipple and areola is lifted to a higher position (mastopexy, breast lift), the nipple remains attached to a stalk of tissue known as a pedicle.

The pedicle contains blood vessels, nerves and ducts that travel from the breast itself to the nipple.

A pedicle ensures that the nipple remains alive during surgery, sensation remains intact, and that breastfeeding might be possible after surgery.

It is very rare for the nipple to be completely removed and reattached after surgery. One type of surgery where this may be done is a reduction of an EXTREMELY large breast (i.e. over 1500 g each breast anticipated to be removed).

When the nipple and areola are removed during surgery and then reattached, this is known as a free nipple graft. This is done to ensure the nipple and areola heal without problems, i.e. as a skin graft.

Karen M. Horton, MD
San Francisco Plastic Surgeon

Nipple most commonly stays attached

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In most instances the nipple is left attached to the breast tissue and gland and the skin is moved around the nipple or the noipple is rearranged within the "skin envelope."

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Nipple Removal

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The nipple is seldom removed before any surgery, including breast lift, reduction and augmentation.

In a lift or a reduction the nipple is left intact to the underlying breast tissue and it is kept on this platform so that it can survive. The the surrounding skin and breast tissue is contoured and then the area is closed.

Only in very very large reductions is the nipple removed and then placed back on. Even this has become very pase' as there are better techniques to allow the nipple to remain attached even in very large breast reductions.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Nipple is rarely 'removed' during breast reduction or lift

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The nipple/areolar complex is rarely 'removed' during breast reduction or lift. With current techniques for breast reduction and lift, the nipple areolar complex is kept attached to the underlying breast tissue to provide blood supply. The surrounding skin is removed and tailored. Rarely would a 'free' nipple graft be performed, perhaps in a very large, pendulous reduction or in a situation where the blood supply is compromised.

Sanjay Grover, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 243 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.