Nipples, made to order

[Simon]

Lately I've been looking at a lot of top surgery results. The one thing I have never seen discussed by any of the guys who have had the surgery is if they had any choice in nipple size (areolas too) or placement.

I don't want big honking nipples but I also don't want tic tacs either. Something about nickel size (in diameter) would be nice and to have them placed right along the pectoral curve would be preferred.

Anyone know how much leeway a surgeon is willing to give us about having a choice in the matter?

[ty.to.the.man]

i talked to my surgeon and she said she would make them the average size in a cis-male (can't remember the number, sorry). Definitely speak up when you go to meet your surgeon, they'll probably address that anyways. I wouldn't be too worried 

[Robert Scott]

I have consulted with three surgeons - all of them show work they have done - discuss body size and what would look good and nipple size & placement.

[Simon]

Good to know. It's just one of those things I've never seen mentioned.

[Nygeel]

There's one doctor whose name I can't remember right now that literally uses a nickel as a template for nipples when it comes to top surgery. There's also the option of getting nipples tattooed on.

[Simon]

There's also the option of getting nipples tattooed on.

I think the tattoo option would be good if (heaven forbid) the grafts don't take. From afar it wouldn't be very noticeable but up close it would be obvious.

I do remember one guy on YouTube years ago that decided not to even have his nipples put back on after surgery. Sadly he was harassed by some in the comments (as is the YT way) and disappeared from the online community. I wonder how many decide not to even have them grafted back on.

[Mr.X]

I am curious now, and wondering why would you opt not to keep your own nipples? I mean, if this is an option, it would seem to me everybody would pick it, right? Or is the nipple placement very tricky and can fail? 

[Nygeel]

I am curious now, and wondering why would you opt not to keep your own nipples? I mean, if this is an option, it would seem to me everybody would pick it, right? Or is the nipple placement very tricky and can fail?

Some people would prefer a tattoo, some people don't care about nipple sensation and don't see much of a point of getting grafts. There might be less down time if you don't have nipple grafts, too.

[Simon]

I am curious now, and wondering why would you opt not to keep your own nipples? I mean, if this is an option, it would seem to me everybody would pick it, right? Or is the nipple placement very tricky and can fail?

I don't know, I guess there could very well be guys with nipple dysphoria. Then there are probably some who don't care if they have them or not.

One of my friends had his top done back in 2001 and one of his grafts didn't take. He thought it was funny. I asked him what he was going to do when he went to the pool. He said he was going to draw it on with pink eyeliner, lol.

[AdamMLP]

I've considered not having nipple grafts from looking at the photos on transbucket because to me they look flatter and better.  I'm just not sure whether I would want to sacrifice nipple sensation entirely for aesthetics.  If the grafts didn't take or I didn't have any nipple sensation -- I don't have that much to start with so losing any would pretty much just give me the sensation of normal skin -- I would be annoyed with myself for not going for surgery without grafts.  One of the things that bothers me most with top surgery isn't the scars but the nipple placement.

[randomroads]

The scars don't bother me much either but the funky nipples do. When people ask me why I have scars I'm going to tell them because I had tumors so the breast tissue was removed. My weird nipples? I'd rather just have them tattooed

[aleon515]

There's one doctor whose name I can't remember right now that literally uses a nickel as a template for nipples when it comes to top surgery. There's also the option of getting nipples tattooed on.

I believe that's Brownstein. It wasn't the point of the video, but he does a very nice explanation and compare/contrast of peri and DI somewhere on youtube.


--Jay

[Liminal Stranger]

I don't think I would care too much re: tattoo vs graft, not like those have proper sensation in them anyway. They have three settings: light touch, cold shock, and cold shock plus pain. So there's not much to miss there.

[Felix]

In order to have my insurance cover the surgery, I'm getting almost all the breast tissue removed and I don't have the option of keeping my original nipples. I have been offered plastic surgery to make fake nipples with tattooing and a little raising of the skin. I'm not impressed by the photos I've seen, but the transguys I've met irl honestly don't have perfect results even with their own original flesh being used.

[Simon]

In order to have my insurance cover the surgery, I'm getting almost all the breast tissue removed and I don't have the option of keeping my original nipples.

Why? The only reason I can think of is your surgeon is trying to "cheat the system" and say you have breast cancer (or something else seriously wrong there).

[Felix]

Why? The only reason I can think of is your surgeon is trying to "cheat the system" and say you have breast cancer (or something else seriously wrong there).

Not cheating the system, just having it paid for the way they pay for it. They have methods for billing preventative medicine but no routine for billing breast removal for a man who shouldn't have breasts. It's OHP CareOregon (temporarily FamilyCare) if you want to look into it. Under mastectomy coding on the prioritized list for the current fiscal year there's no way to bill it as transgender treatment. The codes for trans stuff are vague and very far down on the list. Nobody is being deceptive or cheating anyone, it's just kind of a no man's land in most of the healthcare system.

[aleon515]

I get all my blood tests paid for. My doctor codes it for 3 things. ONe of which I actually maybe have. But one of them is "endocrine disorder". Of course maybe I do have that.

I have heard of some guys getting "reductions". They don't weigh the tissue coming out, let's just say. Most of them have very large chests, so there is some medical reason to get a reduction.

--Jay

[Simon]

Not cheating the system, just having it paid for the way they pay for it. They have methods for billing preventative medicine but no routine for billing breast removal for a man who shouldn't have breasts.

Ok, regardless of the billing/payment issues, will you be satisfied with the results? That is the main thing. The reason it sounds deceptive is because they have to perform the procedure in a certain manner (removing most of the tissue and no nipple grafts). It just sounds like a mastectomy they would perform on a cancer patient.

As long as you're satisfied with what they're offering then go for it. I just wouldn't pick something because it was free or reduced cost if the results aren't what you're after. I'm planning on top surgery Summer of next year if everything goes right and will be paying out of pocket. It's a good chunk of change obviously but I figure a few years from now the money I spent will mean nothing compared to the satisfaction of having exactly what I want.

[spacerace]

I've actually thought about getting no nipple grafts, and then getting a chest tattoo (not nipples tattooed on) that covers that whole area, including scars.  I dunno that I could ever find a tattoo I'd be happy with forever though. The idea of choosing one is daunting.  How do people ever settle on one?

And I keep thinking about that news story a few months back where people got the contaminated ink, so even when they picked a clean, safe place, they were still screwed with some weird skin infection.  This is really rare I think though, and I know tons of people get tattoos with no issues. Still.

[wheat thins are delicious]

I've actually thought about getting no nipple grafts, and then getting a chest tattoo (not nipples tattooed on) that covers that whole area, including scars.  I dunno that I could ever find a tattoo I'd be happy with forever though. The idea of choosing one is daunting.  How do people ever settle on one?

Most chest tattoos I've seen done on post-op guys have been a large piece that incorporates several smaller related tattoos.  I think I could design one for myself with enough thought.

You can mention nipple and areola size to your surgeon.  He may have a way he does things, but the patient's wishes/concerns should be taken into account.