A mastectomy with a free nipple graft is one of the more complex surgical procedures required for patients with a significant amount of enlarged breast tissue. This type of breast reduction surgery includes a few steps to create a sculpted, masculine breast shape.

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What is Mastectomy with Free Nipple Graft?

A mastectomy with free nipple grafting is one of the more extensive surgical techniques used in breast reductions and is often necessary for patients with a large amount of excess glandular tissue. Excess breast tissue will be removed with gland excision and the nipple-areolar complex will be moved to sit proportionately to the newly reduced breast using the free nipple graft technique. This technique removes the entire nipple areola complex as a full-thickness skin graft and then the free nipple is grafted back onto the breast at the end of the procedure.

World-recognized, leader in gynecomastia surgery.


Board-Certified Plastic Surgeon

Dr. Delgado is an award-winning gynecomastia surgeon with 30+ years of experience treating some of the most complicated cases of male breast growth around the world. He is also the owner and operator of Gynecomastia.org, the largest gynecomastia forum in the world that has the goals of educating, supporting, and offering guidance to those men and families affected. Dr. Delgado is an expert in the field and donates his time toward both the treatment of gynecomastia and the advocacy of education in the surgical community.


Who is a Candidate?

This procedure is intended for men with severe gynecomastia and excess skin on the chest. Patients may have a breast size that is equivalent to a size D or higher and often have fat that extends from the breast to the back and under the arms. A high mean body mass index is often attributed to the excess fat partially responsible for the look of enlarged breasts. The breasts may be sagging to the middle of the abdomen and the nipple-areolar complex may be large or puffy, creating nipple projection that is visible through a shirt.

Mastectomy with Free Nipple Graft Procedure

Before your surgery begins, Dr. Delgado will draw surgical markings while you are standing to determine the size of the incision and make sure your results will look great while you are standing or sitting. General anesthesia will then be administered to put you to sleep for surgery. Incisions are usually made in the breast fold extending toward the armpit but the length depends on how much tissue needs to be removed.

Glandular and fat tissue will be removed in the sitting position to account for gravity’s effects on your results. The nipple-areolar complex will also be removed, resized, and reattached to create a proportionate and aesthetically pleasing result. Preserving breast contour by not removing too much tissue is one of the main goals of this technique. Finally, drains will be inserted, and a compression vest will be placed around the chest to minimize swelling and other post-surgery complications.

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I highly recommend Dr. Delgado if you are considering gynecomastia surgery!

– Michael Cruz

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I had the procedure completed about 2 months ago and I am very pleased with the outcome. My chest finally looks the way I’ve wanted it to look for years. The muscle definition is finally there and I can wear tighter fitting shirts and workout gear without the discomfort of feeling self conscious about my chest.

726+ Reviews

I highly recommend Dr. Delgado if you are considering gynecomastia surgery!

– Michael Cruz

I had the procedure completed about 2 months ago and I am very pleased with the outcome. My chest finally looks the way I’ve wanted it to look for years. The muscle definition is finally there and I can wear tighter fitting shirts and workout gear without the discomfort of feeling self conscious about my chest.

Surgical Recovery

If you are an out-of-town patient, Dr. Delgado will recommend that you stay nearby in a hotel for the first few days. That way he will be readily available to help if you have post-surgical complications and you can more easily return for a follow-up appointment. After 2-3 days, you will return for a post-op appointment to remove the drains and after one week, the sutures will be removed. However, Dr. Delgado can use internal sutures that do not need to removed; this way patients from out of the state can return home sooner to rest and recovery.

After surgery, you will be given a compression garment and this should be worn to minimize swelling and other possible complications. Most of the swelling and discomfort will reduce within the first 2 weeks, but you should wait 4-6 weeks before resuming strenuous activity and exercise.

Risks and Complications

Dr. Delgado is an experienced plastic surgeon working with a team of nurses and anesthesiologists who have performed thousands of gynecomastia and breast reconstruction surgeries. However, any surgery does pose some risks. For free nipple grafts, loss of nipple sensation is the most common risk since the entire nipple-areolar complex is removed and repositioned. Swelling and significant bleeding are also possible but recent improvements in the techniques used by Dr. Delgado and his team have reduced this risk to 5-6% of his patients.

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Why Choose Dr. Delgado?

Dr. Delgado is experienced in many types of breast reduction surgery, including mastectomy with a free nipple graft. He will work with care to try and maintain nipple viability and ensure your scars are well-hidden in the natural folds of your breasts. Cases of gynecomastia in which patients have significantly large breasts can be difficult to treat, but Dr. Delgado uses the most innovate surgical techniques for an effective breast reduction.

Schedule a Consultation

Dr. Delgado is one of the highest-trained plastic surgeons for gynecomastia in the country and his experience in all types of reconstructive surgery can help you feel confident in the results you will receive from your breast reduction. Schedule a consultation today by calling our office or filling out an online contact form.

Frequently Asked Questions

Is gynecomastia surgery a mastectomy?

The most common type of gynecomastia surgery is gland excision and liposuction. Gynecomastia surgery or male breast reduction is referred to as a subcutaneous mastectomy. The difference is that no skin is removed, whereas in a mastectomy, both skin and nipple are removed.

Can a man have a mastectomy?

Yes, the severest cases of gynecomastia will require a double incision mastectomy with a free nipple graft. These are categorized as grade 3-4 in the gynecomastia classification.

What are the options for nipples after mastectomy?

A double incision mastectomy with a free nipple graft is performed for men with severe gynecomastia. The nipple-areola complex (NAC) is removed from the chest and placed on the back table. It is then reshaped and resized to masculine dimensions. Once the extra skin is removed and closed, the patient is sat up, and the new resized nipple is placed, as a skin graft, in an ideal masculine position.

What are the complications of nipple grafts?

Complications associated with nipple grafts include delayed healing and loss of nipple of skin sensation.

Do nipple grafts get erect?

Grafted nipples do not have normal functions. The sensation is lost except for touch, and erectile function is lost or severely altered.

What is the success rate of nipple grafts?

Nipple grafts are quite successful about 98% of the time.


Dr. Delgado, MD is a world-recognized plastic surgeon and specialist in the treatment of male breast enlargement, also called gynecomastia. He has developed new techniques and owns and operates gynecomastia.org, which has become the largest gynecomastia forum in the world. Dr. Delgado holds the two most coveted credentials; the certification by the American Board of Plastic Surgery and membership in the American Society of Plastic Surgery.

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