In some cases, the breasts are so massive that the procedure actually requires removing and reattaching the nipples as skin grafts in order to support the blood supply to the nipple (free nipple graft). In Dr. Sayed’s nearly 15 years of practicing plastic surgery, after hundreds of breast reductions, he has only needed to employ this technique in a couple of patients. In general, Dr. Sayed is known for an approach that preserves the right volume in the right places to maintain good central cleavage even after significant reductions.