Age 58, 175lbs, 5'8" - should I be worried about cut off nipple technique?

Question

I had a recent consultation. The surgeon indicated he might need to to cut the nipples off and then reattach during reduction. He said with with larger breasts reducing to smaller, it's common for him to cut the nipple off to lessen blood supply issues. I am concerned about that I'm an H and would like to be a small D. Should I be concerned? I really don't love the idea of losing all sensation and just having a grafted non-sensate nipple. I am 58, 175, 5'8" & active

Daniel Barrett, MD · Answer

Dear fineart111,
breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. The nipples are never detached.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

What you are referring to is called a free nipple graft. There are very few cases where this needs to be done. You may want to get other opinions to determine if that is really necessary.

Camille Cash, MD · Answer

The term the surgeon was describing is a free nipple graft.  This is not necessary with most breast reductions.  It depends on measurements of your breasts and how small you want to go.  I encourage you to visit with a few board certified plastic surgeons to listen to varying opinions.  This should help you decide how you want to proceed.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
When considering breast reduction, one must be aware of the two options of nipple-areolar placement. Pedicle flap repair maintains the viability (and sensation to some extent) to the nipple areolar complex. The flap must remain attached to underlying tissues for survival. In patients with severe macromastia, the flap will be quite bulky and long, limiting the amount of reduction possible, and in some cases, jeoparding the survival of the flap. In this circumstance, the nipple areolar complex is harvested from its original location and is placed as a free tissue graft at the apex of the new breast mound. 
Best wishes...

Age 58, 175lbs, 5'8" - should I be worried about cut off nipple technique?

Answers (5)

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