Keyhole Mastectomy and Nipple Reduction at the Same Time?

Hi, I am a 23 year old female to male transgender who has been on testosterone injections for over a year. I would like to know, if nipple reduction (in length) can be done together with keyhole mastectomy at the same time. I just want my embarrassingly elongated and protruding nipples to be flush and as flat ad possible. My areolas are very small as well. I am within healthy weight range, low body fat and very active in sports. A doctor told me its impossible due to threat of infection

Doctor Answers 7

Nipple reduction at the time of mastopexy or breast reduction

nipple reduction at the time of mastopexy or breast reduction

yes   this is a good idea and is done routinely

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Nipple Reduction at Time of Mastopexy?

Thank you for the question.  I think you may be referring to a mastopexy procedure?

As plastic surgeons  one of our major concerns with the type of operation you are considering is blood flow and the survival of tissues that are manipulated during your procedure. If an incision is used around the areola and nipple surgery is done at the same time you may be at increased risk for blood flow “problems” to the involved tissues. Sometimes, it is better to do these procedures in a staged fashion. In my practice, every patient's care is individualized.

 I hope this helps.  You may also find the attached link instructive.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,501 reviews

Keyhole Mastectomy and Nipple Reduction at the Same Time?

The risk as I see it is not infection, but inadequate blood supply for the nipple to heal. Only an in person exam can determine the relative risks and benefits of doing them at the same time.

If they cannot be done simultaneously, the nipple reduction can be done later as an office procedure requiring only local anesthesia.


Thanks and best wishes.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Nipple reduction and keyhole mastectomy

The solution to your specific breast shape is to undergo the breast removal and replacement of the nipple and areola as separate grafts ie. two grafts per breast. The nipple graft is placed in the center of the areola graft. Each graft is in contact with your healthy skin and will take completely. In this manner, all sizes of nipples and areolae can be customized to your preference.

Sheldon Lincenberg, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 26 reviews

Nipple reduction with top surgery

The easy answer is yes, especially shortening excess length. It is really simple, as the nipple can just be cut short and the raw end heals easily over a few days. Regards, Dr Steve Merten, Sydney, Australia

Steve Merten, FRACS
Sydney Plastic Surgeon
4.9 out of 5 stars 50 reviews

Nipple Reduction at Time of Mastectomy

     Blood supply may be an issue here.  It can be done safely if the right nipple reduction procedure is paired with the mastectomy.  Hard to say without an exam and determining your expectations.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Nipple reduction at the same time as mastectomy

It is certainly possible to reduce the size of the nipple during a mastectomy for trasngender surgery.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.