I'm 5'2, 159 lbs, 46F. I seen a surgeon today and he said I would need a Free Nipple Graft & there was no other options! He said I have "long" breasts and my nipples are positioned far down. I'm stumped because I do want to breastfeed or "try" to and I feel like there's no other option and if there is what is it? My insurance is from the state, so they want a nice size removed, but how much should I get removed and what's an alternative. My back, neck, and body can't take these breasts anymore
Surgeon Says I Need Free Nipple Grafting for my Breast Reduction?
Doctor Answers (8)
Seek one or two additional opinions before having your surgery
Even with the measurements you have provided without at least a photo or better yet a hands on exam it is impossible to agree or disagree with your surgeons opinion. However, from your measurements I would say that the safest form of breast reduction may very well require a free nipple graft approach. My advice would be to seek out one or two additional board certified plastic surgeons for an opinion before you make a final decision. If you are willing to accept perhaps less of a reduction you might be available to avoid a free nipple graft.
Seek a second opinion
Thank you for your question,
Free nipple grafting should be reserved for extreme cases and should
not be a first option for you. Especially since you are planning on
breast feeding in the future. I would highly recommend seeking another
opinion from a board certified plastic surgeon.
Dr. Sam Speron
Alternatives to Free Nipple Grafting Breast Reduction
In long heavy low hanging breasts, free nipple grafting is an option if you want the maximal reduction. But it is not absolutely necessary in breasts like yours if you can live with a little bit less reduction and lift. Since you are younger and want to breastfeed later then this is not a breast reduction technique for you. I would visit other plastic surgeons and get their opinions. It is very likely your next consult may recommend an alternative breast reduction procedure where the nipples are not removed and replaced as skin grafts.
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Breast reduction - do you need free nipple grafts?
Surgeons worry that if the nipple is too low, that the blood supply will be cut during the surgery. This starts to concern surgeons when the clavicle to nipple distance gets over 35cm or so. This is especially true with older "inferior pole" techniques, which leave the nipple attached to tissue at the bottom of the breast only. Find a surgeon that uses superior/medial pole technique, where the blood flow is preserved from the large sternal perforators. With this technique, the nipple rarely needs to be "grafted", as the blood flow to the tissue is inherently better. The final decision can be made at the time of surgery, ultimately if you keep getting that answer then it may not be safe.
Breast reduction without free nipple grafts
Free nipple grafts usually not needed in breast reduction
While there are guidelines for when free nipple grafting is indicated, in women still considering breastfeeding I think the those guidelines can be pushed somewhat. While 46F is large it does not seem so large as to absolutely require free nipple grafting. I would get other opinions prior to aggreeing to free nipple grafts.
Free nipple grafting
Concerns about Breast Reduction Consultation?
Based on your description, it sounds like you may be an excellent candidate for breast reduction surgery. Generally speaking, it is a good idea to seek consultation with a few carefully selected, well experienced board-certified plastic surgeons. If you find that there is a consensus in their recommendations, it is likely that you will feel more comfortable proceeding. Of course, you will have to weigh the pros/cons of having the procedure performed. Also, you will need to consider timing of the procedure in relation to life circumstances (such as pregnancy, breast-feeding…).
Again, seeking additional consultations may be helpful to you.