“Do you have to detach my nipple?”

In my 19 years of practice I have heard this question a lot and I always wonder where this information comes from. At our consultations my patients tell me that they heard or usually read when they consulted Dr. Google, that during a breast lift or a breast reduction the nipples have to be removed from the breasts.

This is unequivocally WRONG. Totally False. Untrue!!

I know you are never supposed to use “always” and “never”, but in this case I’m gonna break that rule and then comes my disclaimer. I “never” detach a nipple during a breast lift and I “never” detach a nipple during a breast reduction. I “always” leave them attached. There, I just broke both rules.

Disclaimer time: There actually is a time when we DO have to detach the nipple. The operation is called a Free Nipple Graft, but we ONLY do this when the breasts are EXTREMELY droopy. What does ‘extremely droopy’ mean. Well, get a tape measure and measure from the top of your breast bone diagonally down to the nipple. That distance should ideally be between 19 and 21 cm. For most patients who need a lift or a reduction the number will be more in the 27-30 cm range. It is only when the number exceeds the 41-42 cm mark that we even discuss detaching the nipple. The other measurement to look at is from the crease under the breast back up to the nipple. Lift the breast and place the tape measure at the crease and then measure back up to the nipple. Ideally that number is 5-7 cm. It’s not until 21-23 cm we that we even start to discuss detaching the nipple.

So, for 99% of women considering a lift or a reduction, detaching the nipples isn’t even remotely a consideration. It just never happens. When we see the kind of numbers I mentioned above, then, and only then, do we discuss the need to detach. Stated another way, in 19 years of practice and having done literally thousands of these procedures, I have never, ever detached a nipple that I didn’t plan on detaching from the get go to extreme breast size and extreme droop.

Lee E Corbett, MD

Corbett Cosmetic Aesthetic Surgery and Med Spa

 

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