Nipple graft placement

Compared to the nipple size, prominence, and position associated with feminine breasts, nipples on cis-male chests are typically smaller, have less projection, and are located more laterally and superiorly (16-19). Anatomic studies have demonstrated the diameter of cis-male nipples to be between 2.0 and 2.8 cm. To account for this, the nipple grafts are harvested using a 25 mm cookie-cutter at the start of surgery. The grafts are later de-fatted with scissors at the back table. De-fatting the graft decreases projection while also increasing graft viability. The nipple position is determined lateral to the midline around the 4th–5th intercostal space, at a point approximately 2.5 cm above the incision and 2.5 cm lateral to the inferior horizontal IMF midline. This site of the nipple graft approximates the usual position of a male nipple when seated and in an upright position (16-19).