Is a reduction with free nipple graft the best option for me due to my breast size?

I am considering a reduction and after a consult have been told that I would need a free nipple graft. My size is 46G/H and the length to the nipple is 44cm and 18cm. I live in an area with few surgeons, should I consider alternatives? The doctor explained the loss of sensation and possible necrosis complications, but also explained that due to the length of the breast the use of the superior or inferior pedicle is risky and would not allow for as much reduction as I would like.

Doctor Answers 7

Free Nipple Graft Technique Great for Massive Breast Reduction

Without an exam it would be impossible to give you a definitive answer. However, from the measurements you listed it sounds like your surgeon has given you reasonable and safe advice.

Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Is a reduction with free nipple graft the best option for me due to my breast size?

Thank you for your question.  Without photos it is not possible to give you an intelligent advice.  However, I personally have carried the nipple/areola on a pedicle in breasts as large as G/H cup.  Much depends on the density of the breasts and how pliable the tissues are.  It is true, the numbers you have provided by definition require a free nipple procedure.  However, I strongly suggest you seek several opinions from experienced board-certified plastic surgeons, even if it means driving and traveling.  I have patients coming in from as far away as Australia to get a breast reduction.  Best of luck!

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Avoid free nipple graft

I never do free nipple grafts breast reductions because the results are so poor. The nipple is numb and necrosis frequently occurs. There is a new alternative called The Ultimate Breast Reduction(TM). This technique reshapes your breast tissue creating upper pole fullness, elevates them higher on the chest wall and more medial to increase your cleavage. The size can be adjusted as desired and pain is relieved by transferring the weight of the breast to the underlying muscle. I have done this procedure on a woman as large as a 44 M. This technique does not leave the ugly vertical scars, maintains nipple sensation and the ability to breast feed. Best Wishes, Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Is a reduction with free nipple graft the best option for me due to my breast size?

It is very difficult to answer your question without photos or a physical examination. While the 44 cm from sternal notch to nipple precludes a superior pedicle reduction, you may still be a candidate for and inferior pedicle reduction if the distance from the inframammary crease to nipple is 18 cm.

Much depends on your desired size after the procedure as well as your height and weight.

Getting a second opinion is always a great idea if you have questions or concerns. Doing your research before surgery will give you comfort and peace of mind for your procedure. Good luck.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Preservation is possible

Although distance from the sternal notch to nipple does help determine the ideal technique, it is hard to tell without photos or an exam, whether or not you "need" a free nipple graft. I use this technique but less and less now although very large reductions may be best suited with a FNG. Best to seek other opinions, even if it means traveling a bit out of your way. Other surgeons may concur or feel comfortable attempting preservation of the nipple.

Glenn Lyle, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast reduction and free nipple graft

I have performed many breast reductions over the years and also do free nipple graft procedures when indicated. Even on very large breasts, it is rare that I do a free nipple graft. It is best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Is A Free Nipple Reduction Mammoplasty the Best Option for A woman with A BRA size of 46G/H

Unfortunately, I am afraid the the free nipple technique would be your best option. Most plastic surgeons will do a free nipple technique if the distance from the nipple to the crease beneath the breast is 16cm or greater. 5% of my breast reduction patients are candidates for the free nipple technique. Good Luck

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.