I have worked with about half a dozen women over the last few years who have had breast reductions.  You are correct in that the type of surgery is the key to whether breastfeeding is preserved.  Often the women have no idea whether the nipple was removed or not.  Only one of the women I have worked with went on to successfully breastfeed and she eventually began giving one supplement per day after about a couple of months for "slow weight gain."  Another women I worked with was able to partially breastfeed and a third was able to transfer colostrum to her baby but when milk production began she experienced severe engorgement with little milk transfer to the infant and unsuccessful manual or mechanical expression of milk.

I followed these moms post discharge with outpatient visits where I assessed the baby at breast and did pre and post weights to gauge the approximate amount of milk transfer.  

One interesting thing of note: the woman who was able to successfully breastfeed lacked the typical circular scar around the boarder of the areola. 

Hope this helps
Stacy Miller-Leonard RN,MS,IBCLC
Chicago suburbs

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