Keyhole Mastectomy and Nipple Reduction at the Same Time?

Question

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

Jed H. Horowitz, MD, FACS · Answer

nipple reduction at the time of mastopexy or breast reduction

	yes   this is a good idea and is done routinely

Steve Merten, FRACS - Account Suspended · Answer

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

Kenneth Hughes, MD · Answer

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.

Sheldon Lincenberg, MD · Answer

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.

Steven Wallach, MD · Answer

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

Tom J. Pousti, MD · Answer

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.

Jourdan Gottlieb, MD · Answer

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.

Keyhole Mastectomy and Nipple Reduction at the Same Time?

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