The Free Nipple Graft Breast Reduction Technique and the Appearance of the Nipple-Areola Complex

Among the many ideal goals in breast reduction surgery is to preserve the general appearance of the nipple and at least some sensation. These can be achieved much of the time with procedures that maintain the attachment of the nipple to the underlying tissues including ducts, nerves and blood vessels. However, for those women with exceptionally massive breasts, a procedure called a free nipple graft breast reduction may offer them the best opportunity to obtain more ideal results.

This technique facilitates the removal of an appropriate volume of breast tissue and with greater finesse while allowing for more ideal breast contouring with greater predictability of results, shape and durability. The scar pattern is the same as that of most other techniques. However, the biggest drawback to this approach is that the nipple-areola complexes are removed as “skin grafts” to be placed back on the breasts later in surgery at an ideal position. Their blood supply and nerve fibers are necessarily disrupted and their survival will depend on re-growth of the circulation. Because of this, most nipple-areola complexes will display some degradation of their normal anatomy.

What are some of these visual changes? Commonly, there is loss of some or all of the nipple projection and what may remain is a semblance of a nipple. The areola may also be thinner and not as domal shaped. Darker complected individuals also have a substantial risk of depigmentation of the areolas, either temporary or permanent. As with any skin grafting procedure, there is a risk for partial or total failure of the nipple-areola complex to heal and survive. This risk is higher particularly in smokers, diabetics and those with autoimmune disease.

The photo below demonstrates the appearance of a nipple-areola complex in one of my patients who underwent this free nipple graft breast reduction. She has maintained some nipple projection and has not lost pigmentation.

Breast reduction with free nipple graft

If you would like more information on a reduction mammoplasty or any other plastic surgery procedure that I perform or to schedule a free cosmetic consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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