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.