Second breast reduction 15 years after first reduction. Can 415~cc (B cup) be removed without having my nipple removed? (Photo)

The technique I recommend is The Bellesoma Method.  This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief and long term stability.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Nipple removal is not required.Best Wishes,Gary Horndeski, M.D.

Dear Gregarious7659,
breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I am sorry to hear about your concerns after previous breast reduction surgery. It is generally safe to undergo additional reduction surgery but care must be taken to avoid complications.
One of the concerns when repeating breast reduction surgery is related to blood flow to the remaining breast tissue; is important to perform the operation in such a fashion that the blood flow to the nipple/areola/breast tissue is not compromised. The part of the tissue that is left in place after breast reduction surgery is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola/ breast tissue. If the pedicle (that was used during the previous breast reduction procedure) is cut then the blood flow to tissues may be compromised leading to serious complications such as tissue necrosis etc.
 Make sure that you communicate your size goals carefully; in my practice, I encourage patients NOT to use cups sizes as references;  the use of visual aids such as photographs are much more helpful.In your case, based on your photographs, further movement of the nipple/areola complexes will likely not be necessary; an excision of 415 cc will likely not be necessary either.
I hope this helps.  Best wishes.

Your nipples are in a good position, so a vertical reduction could be performed without moving the nipples.I dont believe that you will need as much as 450 grams removed

Hi and welcome to our forum!
The major concern with secondary breast reduction is the blood supply to the nipple - areolar complex. During the initial operation, the surgeon created a pedicle flap upon which the nipple areolar complex receives its blood supply. It is extremely important to base the new flap in the same direction as the primary procedure to preserve the blood supply (as some surgeons base their flaps inferiorly and some superiorly). Therefore it is important to have the operative record of the initial treating physician if you are seeing a new surgeon. It does not appear that you require nipple areolar grafting.
I am unable to determine the anticipated volume reduction from a photograph. In-person evaluation by a board certified plastic surgeon is required.
You will require medical evaluation and clearance for surgery from the physician(s) treating your medical conditions.
Best wishes...

I am sorry that you have had medical conditions since your last surgery.  Prior to the second reduction be sure to get medical clearance from any and all treating physicians.  Your nipples appear to be in good position, so a vertical lift should give you a nice result.

Hello there and thank you for your question.
It is better to perform it with nipple lift, without nipple repositioning your breast and nipple can be ptotic. I recommend you to discuss this with your doctor who will perform your surgery.
Best Regards
Evren Helvacı MD