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Updated: May 13, 2026

Mammary Epithelial Transplant Procedure
Published on: June 10, 2010
Nipple reduction using the mushroom flap technique for male transgender
Akaradech Attainsee1, Korakod Bocam2, Kamol Pansritum3
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok 10400, Thailand.
Abstract:
Nipple reduction is a well-established procedure that is widely used and can improve the self-confidence of male transgender individuals. The nipple reduction procedure in male transgender individuals differs from that in cisgender females due to a greater disparity in postoperative nipple sizes compared to preoperative sizes. Flaps used in male transgender nipple reduction should be simple to avoid skin necrosis. We present the nipple reduction of a 25-year-old male transgender patient using the mushroom technique. A 6 mm circular line was drawn at the most prominent part of the apex of the nipple. Another circular line was created at the base of the nipple. The skin and subcutaneous tissue were removed. The original diameter of the nipple was reduced. The two circular lines were re-approximated and sutured. Both right and left nipple height was 7 mm, and the width of the right and left nipple was 12 and 13 mm, respectively. The new nipple height and width of both sides at six months postoperative were 3 mm and 6 mm, respectively. The nipples were healed uneventfully, and the patient reported high satisfaction and self-confidence. This method can be used as a promising alternative to previously described techniques.

