How does the footprint of the original breast affect the final size and shape?

The pedicle is created to maintain blood flow and innervation to the nipple.  With a free nipple graft, the pedicle can be made as small as desired.   Nipple grafts however do not typically heal as well and sensation is lost.  Your breast width will not change.  Discuss these details with your surgeon.  Best wishes!

Dear ukwoman,
It is possible to reduce breasts of HH cup to a D cup without needing to resort to free nipple grafts using the vertical scar (lollipop) technique. The footprint gets smaller in all dimensions with eh breasts moving up on the chest, the cleavage lets crowded and the side boob decreased a lot. I do this often in my own practice.. I have been using the vertical scar technique in very large breasts for the past 27 years

Hi, it may be possible to slightly narrow the footprint of the breast (or give the appearance of having done so). With any breast reduction there is a skin excision as well as that of breast tissue. Some women have quite wide breasts and it is possible to make the breasts more narrow by removing more skin and breast tissue.
Whilst it is theoretically possible to reduce from HH to an A or B cup it would be very difficult to give you any decent shape or form to the breast. It is important that you have realistic expectations of what can be achieved and you should discuss these in full with your plastic surgeon.

Thank you for this complex question. A breast reduction will make your breast smaller and reduce the amount of breast tissue that typically hangs below the breast fold. The foot print of the breast tissue if often similar with less breast ptosis (sagging). If you look at many of the before and after photos for breast reduction you will notice that the width of the breast is typically the same but there is less breast tissue hanging. A free nipple graft can help to make the breast smaller but the width of the breast is typically the same and the projection of the breast is what would be less. I hope this answers your question.