Removing fat without losing nipple sensitivity. What procedure would be best? (Photo)

Thanks for your question and the photo you provided. It appears as though your problem is loose and excess skin rather than fat. So any other procedure that does not involve skin excision will not give you a better chest contour. Not every patient looses nipple sensation. However, if you are not prepared for the possible risks of a procedure, you should hold off. Good luck, be sure to consult with a board certified plastic surgeon.

The only way for you to obtain the outcome you are seeking (in my opinion), is to remove the nipple-areola complexes as free nipple grafts and reapply them after removal of all the excess skin and fat. This is sometimes the only solution for the degree of gynecomastia that is demonstrated in this photo. This unfortunately comes with loss of some nipple/areola sensitivity.

From your photo, you have significant loose skin in addition to fat. If fat removal is only your concern, liposuction alone without skin excision would minimize the risk of nipple sensation loss. However, if you want a contoured chest, skin removal would be necessary. To optimize protection of sensation, I would recommend a pedicled nipple flap approach. I would not recommend a free nipple graft in this case as this technique would have 100% chance of sensation.

Most likely you have condition known as pseydogynecomastia. Breast enlargement after significant weight gain and loss will created female like breast with stretched, saggy skin. In your case, best option to correct current deformity would be male breast reduction with removal of stretched skin and placement of nipple/areolas in better position. Depending of technique used, you may expect horizontal or keyhole pattern scars. Sensation is expected to be decreased but still present once healing is over. In person consultation with a board certified plastic surgeon, is recommended. Good luck.

Dear Nice588341,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

Any intervention on the chest wall can result in a loss of sensation. Liposuction probably has the lesser risk of this happening. However, given the picture that you provided, you may require a skin excision. There are options for maintaining the nipple on a pedicle of tissue that can often result in maintenance of the sensitivity of the nipple. However, this is a scenario that you will have to understand has very unpredictable results. No one can guarantee that you will have ongoing sensation, and if this is a hard stop for you, then it may not be in your best interest to proceed with surgery. Have a frank conversation with your board-certified plastic surgeon about your goals. We are happy to help in any way we can.

You have fatty tissue as well as excess skin likely after weight loss. Any surgical procedure on the breast can result in a change in nipple sensation which typically is temporary in nature. But not always.
I prefer to stage gynecomastia procedures which require removing extra skin by performing liposuction with pull through breast tissue removal, followed 6 months later with skin reduction surgery. The skin reduction or male mastopexy does require incisions on the chest either a transverse line across where the crease is or a lollipop/ anchor incision. Staging the two procedures at will have the highest likelihood of preserving nipple sensation.

What you need is a wedge excision of skin tissues with a nipple and areola transposition, and combined with liposuction. this procedure will optimally contour your breast and avoid nipple sensation loss. Please consider a virtual consultation with a high definition body contouring expert.