Is free nipple graft necessary for all breast reduction surgeries?

breast reduction is most commonly done with a pedicle technique, in which the blood and nerve supply to the nipple is maintained on a column of breast tissue called Pedicle while surrounding tissue is removed. This maintains the sensation of the nipple. Free nipple graft technique is rarely performed and only when the breasts are  extremely large .   I suggest you seek consultation from at least two or three Board certified plastic surgeons and talk specifically to them about their technique Good luck!

Thank you for you question,           The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. The nipples are never removed.  Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. Best wishes and kind regards, Dr. Gary Horndeski

I have personally not needed to consider nipple grafting, even on some of the longest breasts, after switching to the LeJour technique.  All breast lift and reduction surgery, though, carries a small risk of poor nipple healing or loss of sensation.

Free nipple graft in the best of circumstances may have a little bit of pigment change.  All sensation will be lost as well as projection.  The graft may not look natural or even survive.  Most methods of breast reduction can usually account for tremendous size reduction without performing a free nipple graft.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

No, it is very uncommon to have to do a nipple graft - only in about 1% of breast reductions does this need to happen.  There can still be changes in sensitivity depending on the technique used.

Thanks for you question.  Short answer is no.  A free nipple graft is a technique that is only used in extreme circumstance where the blood supply to the nipple-areola has been compromised during the procedure or when the distance from the clavicle to the nipple is excessively long (e.g. 1.5-2 feet).  Nipple sensitivity after a breast reduction can never be absolutely guaranteed, however with a properly performed reduction, the possibility of complete loss of sensation is quite low.Many patients similar to yourself achieve a fantastic result with a reduction using the Bellesoma technique.   
Bellesoma is a new breast lift and reduction technique that seems like it would be a great fit for you. The Bellesoma procedure reduces the heaviness of your breast, lifts your breast, preserves the nipple sensation, and looks as full and perky as if an implant had been placed without using any implant, so no need to compromise.  One of the huge positives of this technique is that there is no vertical incision traveling down the front of your breasts.
Some of the differences between Bellesoma and the traditional breast reduction techniques:
-Bellesoma creates upper pole fullness that traditionally needed an implant to achieve.
-There is NO vertical scar, only well-hidden scars in the fold under the breast, and around the areola.
-The breast is dynamically supported by attaching it to the muscle, so there is no recurrence of sagging which are expected with traditional lifts or reductions.
-The entire central portion of the breast is undisturbed, so nipple sensation remains intact and is very unlikely to be compromised.
-For absolute best results, patients should have a stable weight and have a BMI under 30.
The procedure is accomplished by using the skin of the lower pole of the breast (the part below the nipple that sits in the bra cup) to shape the whole breast into a perky dome, then straps are made of the extra skin, anchoring it to the underlying chest muscle so that there is virtually no chance of repeat sagging.  The skin that above your nipple and below your collar bone is utilized to cover the perky, lifted dome that has been created and then a new (usually smaller) circular opening for the areola is placed at the high point of the cone, creating your new lifted, full and shapely breast.
Especially because of your concerns, you seem as if you would be a very good candidate for this new technique and should really get the look that you are desiring without implants or unnecessary visible scars. I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons in your area or an area that you would like to travel to on holiday who offers the Bellesoma technique to discuss your breast reduction and possible results.
Best wishes!
Dr. Brown
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Free nipple grafting with breast reduction surgery is not done routinely anymore except in extreme cases. Most reduction techniques now keep the nipple on a pedicle if breast tissue. Although it remains attached, there can be alteration to sensation. If you are very concerned about alteration of nipple sensitivity, do not have surgery on your breasts. There are no guarantees. Best wishes. 

Free Nipple Graft technique is used for women with extremely large breasts. You can still achieve the same overall shape of the breast with this technique, but the nipple sensitivity will be changed. This is the technique chosen when the breast is so large, that the pedicle technique may have an increased risk of the blood supply not getting to the nipple as it is too long. I would recommend you get a consultation after your research from a board certified plastic surgeon in your area.

Breast reduction surgery tends to be one of the most patient pleasing operations we perform. It is the rare patient that requires free nipple grafting; the vast majority patients are able to undergo breast reduction surgery using a "pedicle technique". My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as  well.  In our practice, this is often best done with the help of goal photographs and computer imaging. Working together you will come up with a good plan to achieve your goals.  
Best wishes.