Is a free nipple graft really necessary? My surgeon says it is due to my size (Photo)

Thank you for the question and picture. Although, this may not be answering your question directly, I think that you will be better off achieving close to your long-term stable weight prior to proceeding with breast reduction surgery. Doing so will decrease risk of complications and likely improve outcome as well. Then, choose your plastic surgeon carefully and allow him/her to use their best judgment when it comes to the details of the operations such as technique utilized (hopefully based on many years of experience) to achieve the best outcome possible.  Best wishes.

By the appearance in your photo you appear to be a good candidate for a free nipple graft breast reduction. I would trust your plastic surgeon and his/her experience if you feel comfortable with him/her. This is a decision that has to be made with a formal consultation and examination.