Is it possible to have top surgery without having the nipples removed, revised, or graphed on? I enjoy the sensation in my nipples and do not want to lose that. Or would a breast reduction be a better option? Basically I want a flat chest with my original nipples.
January 3, 2017
Answer: Preserving nipple sensation with FTM chest masculinization In general I agree with the other doctors that have posted. I have a frank conversation with each patient as to what is realistically attainable. Depending on the patients anatomy and amount of skin below the nipple a non cumbersome pedicle and be developed and sculpted to appear as pectoral muscle bulk. For patients that do not derive significant pleasure from their nipples this is a wasted venture and adds complexity. For those that strongly desire nipple sensation it can be very advantageous and no vertical scar is necessary. Healing is quicker and more reliable than with free nipple grafts. The technique has to be tweaked for the individual's body, chest wall and skin excess. Not all patients are reasonable candidates for sensate nipple FTM chest masculinization. I hope this helps!Rian A. Maercks M.D.
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January 3, 2017
Answer: Preserving nipple sensation with FTM chest masculinization In general I agree with the other doctors that have posted. I have a frank conversation with each patient as to what is realistically attainable. Depending on the patients anatomy and amount of skin below the nipple a non cumbersome pedicle and be developed and sculpted to appear as pectoral muscle bulk. For patients that do not derive significant pleasure from their nipples this is a wasted venture and adds complexity. For those that strongly desire nipple sensation it can be very advantageous and no vertical scar is necessary. Healing is quicker and more reliable than with free nipple grafts. The technique has to be tweaked for the individual's body, chest wall and skin excess. Not all patients are reasonable candidates for sensate nipple FTM chest masculinization. I hope this helps!Rian A. Maercks M.D.
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May 19, 2016
Answer: Nipple sparing top surgery Thank you for your question. In my experience, most trans men (like yourself) want as tight and flat a chest as possible with as much definition to the pectoralis muscle as possible. This would not be able to be achieved with a breast reduction alone as there will still be a "pedicle" of breast tissue beneath the skin flaps that is necessary to keep the nipple areola complex alive and sensate. The reason to do the breast reduction method then becomes solely to maintain as much nipple sensitivity as possible for those trans men that postop maintenance of erotic sensation of the nipples is important. Even with this technique there is no guarantee of maintenance of nipple sensation. With the standard double incision top surgery with free nipple grafts, the contour is usually superior, scar placement can be optimized into the inframammary crease only ( as opposed to the breast reduction anchor configuration which is periareolar, vertical AND inframammary), and nipple placement can be achieved into a more masculine position further lateral on the pectoralis muscle. I hope this helps and best of luck with your transition!!
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May 19, 2016
Answer: Nipple sparing top surgery Thank you for your question. In my experience, most trans men (like yourself) want as tight and flat a chest as possible with as much definition to the pectoralis muscle as possible. This would not be able to be achieved with a breast reduction alone as there will still be a "pedicle" of breast tissue beneath the skin flaps that is necessary to keep the nipple areola complex alive and sensate. The reason to do the breast reduction method then becomes solely to maintain as much nipple sensitivity as possible for those trans men that postop maintenance of erotic sensation of the nipples is important. Even with this technique there is no guarantee of maintenance of nipple sensation. With the standard double incision top surgery with free nipple grafts, the contour is usually superior, scar placement can be optimized into the inframammary crease only ( as opposed to the breast reduction anchor configuration which is periareolar, vertical AND inframammary), and nipple placement can be achieved into a more masculine position further lateral on the pectoralis muscle. I hope this helps and best of luck with your transition!!
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May 14, 2016
Answer: No promises! Any breast reduction technique whether the nipples are not relocated (rare) can alter sensation. No surgeon should promise the preservation of nipple sensation following breast surgery even if liposuction is the only approach used. You have to be willing to possibly diminish or lose sensation with Top surgery.
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May 14, 2016
Answer: No promises! Any breast reduction technique whether the nipples are not relocated (rare) can alter sensation. No surgeon should promise the preservation of nipple sensation following breast surgery even if liposuction is the only approach used. You have to be willing to possibly diminish or lose sensation with Top surgery.
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