BreastHealthOnline's Position on Free Nipple Grafts

At BreastHealthOnline, one of our main missions is to educate our members. Bearing that in mind, we have taken a strong stance on the Free Nipple Graft procedure.

The subject of free nipple grafts is a touchy one, because this procedure results in the loss of sensation and possibly reactivity in the nipple as well as the loss of the ability to breastfeed. Consequently, BreastHealthOnline wants all members to know the facts about free nipple graft before they have their surgery. If at all possible, having a free nipple graft should be a conscious decision of the patient and not the choice of the surgeon. All breast reduction patients should be aware that there are situations where the surgeon performs the free nipple graft procedure due to complications during surgery in order to save the health of the nipple, and all breast reduction patients should know that this is a possibility. All breast reduction patients should be aware of the reasons for using the free nipple graft procedure and what the results will be.

The free nipple graft was previously the main technique used in nipple placement during breast reductions. For a plastic surgeon, this technique is also the easiest one to perform. Remember that just because your doctor is a plastic surgeon does not mean he is highly skilled in breast reduction techniques, unless of course he specializes in that area of plastic surgery, which some surgeons have done. Many surgeons who are not highly experienced with breast reduction may not have the skill required to preserve nipple integrity and therefore opt to use the free nipple graft procedure. We suggest you look for a surgeon who has more experience performing breast reductions without routinely using the free nipple graft procedure, and we also recommend that you have at least three consultations with different surgeons. Since a free nipple graft means loss of all sensual feeling and possibly nipple reactivity, as well as the ability to breastfeed, we want to make sure a woman understands the ramifications of a free nipple graft before she chooses to have one.

As medicine has advanced, the Free Nipple Graft has been replaced by other techniques.  This doesn't mean that a Free Nipple Graft never needs to be done. There are circumstances where it is indicated because of a woman's notch to nipple (N2N) and/or fold to nipple (F2N) measurement or because there has been a complication during surgery that has caused the nipples to lose their blood supply. Our concern is that we have had too many reports of women who have had a Free Nipple Graft when it was not medically necessary.  It is this practice that we want to educate women about.

If you have had a free nipple graft, we hope you are happy with the results of your surgery and that your breasts are the size you anticipated. That, of course, is the outcome we all desire. Regardless of the technique used for your breast reduction, you will find the same compassion, support and empathy here that every other woman receives.

Free nipple graft is a difficult topic. There are two distinct sides to it. One side is educating women about it before they have surgery. In doing so we must present them with all their options so that they can make informed decisions about their care. On the other side are the women who have had free nipple graft and who need information and support after their surgeries. Sometimes these two sides collide because a woman who has had this type of surgery is also reading all of the preventative information we have for those just starting out. This can result in them feeling as though they did not do enough to prevent free nipple graft. This is never our message, but because we take such a strong educational stance about free nipple graft it is sometimes the result, and we apologize for this. We have recently taken steps to help present the information and our support in a way that better serves the women facing this procedure, as well as those who have already been through it. We will continue to do everything we can to offer the best information and support that we can.

  • Saturday, 16 June 2012