Free nipple graft vs. the anchor method? Recommendations, healing differences, and options?

Question

32J & just had consultation - was informed my options were either anchor or FNG. However, with the anchor I will only be brought down ~1/2 my breast size (1000+ g each), which is still way too large for my preferences (chronic neck pain + headache sufferer). My PS discouraged me from the FNG because I am 23, but I am fine with not breastfeeding any future children (in ~7 years, too). Any thoughts? And are there any healing differences or risks? Will an FNG look "normal" still coming from a 32J?

Reza Momeni, MD, FACS · Answer

For patients with very long breasts, many plastic surgeons do not feel the anchor method is safe enough to allow the nipples to survive, and so they perform free nipple graft.  Without an exam in person, it's impossible to say what should be done in your case.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

FNG are a solution of the past in my opinion.  I have use a technique (see video) that preserves the cosmetic appearance to the nipple and areola that a FNG DOES NOT achieve.  I have remove upward of 3000 grams per breasts  with this technique.  The use of an anchor incision pattern with a standard retention of your natural nipple/areola can be option depending on your physical exam.  Best wishes

Kenneth Hughes, MD · Answer

Free nipple graft in the best of circumstances may have a little bit of pigment change.  All sensation will be lost as well as projection.  The graft may not look natural or even survive.  And as you mentioned, breastfeeding will not be possible.  Most methods of breast reduction can usually account for tremendous size reduction without performing a free nipple graft.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Kelly Killeen, MD, FACS · Answer

I would recommend a second opinion.  It is almost never necessary to do a free nipple graft, certainly not in a 23 year old.  I typically do breast reductions with a lollipop scar, rarely with an anchor.  Even larger reductions can be done in this manner with beautiful results.  Good Luck!

Steven Wallach, MD · Answer

I almost never have to do a free nipple graft.   But in the cases that I do, I use an anchor incision and make a glandular pedicle as well. Good luck.

Free nipple graft vs. the anchor method? Recommendations, healing differences, and options?

Answers (5)