Procedures

[ItsGoneIn2019]

So I just had a consultation. I was given two options: one to have my nipple grafted back on, which would result in a flatter chest, but potentially discolored nipples, and a second option where my chest wouldn't be as flat, but the nipple would be normal. The second option involved folding the fat in some manner under the nipple.

The first option seems like the better option for me, but the discolored nipple puts me off a bit. For the second option, I am wondering if I could just work out and make my chest shape hide it in some manner. I am also wondering what it looks like to begin with.

I am obviously not asking which is the better solution here: that is at my discretion. I am wondering about the second option, how it looks, and how I could, potentially, work around it (if even necessary).

[Dr. Elliot Jacobs]

Both of these procedures are used when the breasts are large, heavy and droopy.  The first procedure, in which the nipples are placed on the chest after the excess tissues have been removed, results in a flat and taut chest.  The nipples may lose some pigment -- and sometimes not.  If pigment is lost, then it can be replaced with a medical tattoo.

The second option, in which the nipple remains attached to a tongue of tissue (which provides blood supply), will leave, at best, some residual tissue on the chest.  Thus, a trim, taut and chiseled chest may not be possible -- but the nipples will retain sensation and color.  Trying to workout to hide or change the results is probably not possible.

Dr Jacobs

[Dr. Schuster]

I agree with Dr. Jacobs' description. Both will leave you will significant scars so I generally recommend the first option. 

[ItsGoneIn2019]

I have decided to go with the first option. I prefer a flatter chest and changed my mind about the nipples. As far as I'm concerned,  I don't even want them anymore. Thank you. Both of you.

[Litlriki]

Without seeing photos of your chest, I can't comment on your situation specifically, but I've found that I can almost always preserve the connection to the nipple as described in the second option, and in the few situations where there's still been fullness in the lower chest due to the "tongue of tissue"--the pedicle of the flap supporting the nipple--I have corrected this at a later point with some liposuction under local anesthesia in the office in a very minor procedure. I have done the free nipple graft procedure, but only when the breasts were too big to do the small flap. In your case, the graft may certainly be the better option, so I don't mean to question your decision, only to point out that both circumstances can result in a pretty flat chest. 

[ItsGoneIn2019]

Mine are actually quite large, so the graft is probably the way to go, given your response.  Thank you for the feedback. 

[DrPensler]

I have done thousands of gynecomastia procedures and have never had to resort to free nipple grafts for gynecomastia. As far as the second description I really am not at all certain what you are describing. Someone said photos would be useful and I agree with that.