A free nipple graft procedure for gynecomastia entails removing the nipple areola complex from the chest skin and using an incision along the lower chest fold to elevate the skin away from the glandular tissue. The excess tissue is removed and the skin is pulled inferiorly towards the incision and tailor tacked. The nipple areola is then placed back on the chest and secured as a free graft. This technique will often get the flattest chest for those with excess skin and gland/fat. The main disadvantage is that the nipple usually will not regain sensation, and it may lose pigment.