Ask Dr. Pane I'm having a mommy makeover, I have large breasts do I need a free nipple graph

Hello everyone, and welcome back to Atlantic Coast Aesthetics. I'm your live streaming host, Matt, and today we're joined by Dr. Thomas Pane. Just as a quick note, we'll be rebranding the channel soon to Dr. Thomas Pane MD, so keep an eye out for that. Dr. Pane, we had a question come up today regarding a mommy makeover, specifically about the need for nipple grafting. Could you shed some light on that for us?
Certainly. When we perform a breast lift or reduction, the external scars typically form an inverted T shape, circling around the areola, down the breast, and along the base curve. However, what's happening internally can vary based on the technique used. In my practice, I prioritize preserving the nipple by carrying it on a block of tissue as it's repositioned. This helps maintain sensation and blood supply to the nipple. While it's rare for me to encounter cases where the nipple needs to be completely removed as a free nipple graft, it can happen if the breasts are exceptionally large.
In such cases, where the tissue being brought up is insufficient to support the nipple, a free nipple graft may be necessary. However, this comes with drawbacks such as loss of sensation and the inability to breastfeed, making it less preferable compared to preserving the nipple with the natural tissue. Fortunately, in my practice, these instances are uncommon, thanks to the techniques I've learned and refined over time.
I learned many of these techniques during my plastic surgery rotations in general surgery, where I encountered experts who emphasized preservation methods. While I've integrated a combination of techniques into my practice, the emphasis on preserving the nipple whenever possible stems from this early training.
In certain cases, such as male-to-female gender transition surgeries or gynecomastia procedures, where a flat chest is desired, free nipple grafting may be advantageous. However, for routine mommy makeover procedures involving large breasts, the need for free nipple grafting is minimal.
Nevertheless, it's essential to assess each patient individually, considering factors like breast size, sensation, and overall health. While we strive for optimal outcomes in a single procedure, safety remains paramount. In some cases, dividing the procedure into separate sessions may be necessary for patient safety and to ensure the best results.
Ultimately, our goal is to provide safe, effective procedures with minimal risk and optimal outcomes. We encourage anyone with questions or concerns to reach out, and we'll be happy to address them. Thank you for your time, Dr. Pane, and if anyone has further questions, please refer to the description below for our contact information and social media links. We look forward to assisting you further.