Gender-Affirming Care · May 24, 2026 · 5 min read
Nipple Grafts vs. Nipple-Sparing Top Surgery
Your nipple options shape sensation, scarring and the final look. Here’s how grafts and nipple-sparing techniques compare.
This article is general information and education — not medical advice. Everyone is different, and your surgeon or medical provider will know what’s right for your individual circumstances.
When planning top surgery, one of the most personal decisions is what happens with the nipples. The right choice shapes sensation, scarring and the final appearance — and there’s no single “correct” answer.
Free nipple grafts
With the double-incision technique, the nipples are removed, resized and repositioned on the chest as grafts. It’s a common approach for medium to larger chests; because the grafts heal in a new position, sensation is typically reduced.
Nipple-sparing techniques
Keyhole, periareolar and nipple-sparing double-incision keep the nipple connected to its own blood and nerve supply, which tends to preserve more sensation. Suitability depends on your chest size and skin elasticity.
Going without nipples
Some people choose a smooth, flat chest with no nipple reconstruction at all. It’s a valid, personal aesthetic choice — and one we fully support.
The takeaway
Your chest, your goals and how you feel about sensation all guide the approach. Our Choosing Your Procedure guide compares the options, and a consultation makes the decision clear.
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