Do I really need a free nipple graft?

In my experience I am able to successfully use a more traditional approach using the lollipop or inverted T procedure without resorting to a free nipple graft technique for a DDD to C  cup reduction. Free Nipple Graft is only required in reduction of massively enlarged breasts (typically larger your cup size. It results in inability to breast feed, loss of sensation, loss of nipple projection, incomplete take of the nipple/areolar graft and other complications can occur with this procedure. In my practice this is a very unusual as even very large breasts can be reduced with other techniques. On the other hand this is a technique that should be considered when it is expected that there is not sufficient blood supply for the nipple and areola survival in extreme cases. One option your surgeon can try is to see if the nipple/areola has a sufficient blood supply at the time of surgery. If not he can then choose to use this technique.

At
size 40 DDD each 300 gram removal corresponds to 1 cup size change.900 gram removal (approximately 2 lbs) would
take you down to a size C.I have
removed 5 lbs on a patient without requiring a nipple graft.Her nipples hung to her wrist and she underwent
a lift without a nipple graft while maintaining nipple sensation and the
ability to breast feed.I recommend a
new technique called The Ultimate Breast Reduction™.The breast tissue is reshaped creating upper
pole fullness, elevated higher on the chest wall and more medial to increase
your cleavage.The weight of the breast
is transferred to the underlying muscle resulting in immediate pain relief
without excessive reduction.This
technique avoids the ugly vertical scars of the traditional technique,
maintains nipple sensation and the ability to breast feed.Best Wishes,Gary Horndeski, M.D.

If you wonder whether or not a nipple graft is necessary it probably is a good idea to get a second opinion. Posting the photograph would be useful as well.