I had a consultation with a woman today for a breast augmentation.  She was very concerned about nipple sensibility after breast augmentation and inquired if it is possible to lose sensation with the procedure. 

Unfortunately, sensation changes of the breast skin or the nipple and areola can occur following breast augmentation.  If you look at the data available from the manufacturer from a study involving 901 patients using saline implants, the reported rate for moderate or greater loss of sensation is 8% at 3 years.  This sensation loss ranged from having no feeling in the nipple or breast to having partial feeling or strange sensations.  The changes that a patient experiences may be temporary or may be permanent.   This depends on the type of injury a nerve experiences during the surgery.

So how do you reduce the risk for sensory loss following breast augmentation?  There are several things to consider for this.  In the past, anecdotal evidence suggested that the incision used may impact breast sensation.  However, recent literature indicates that choice of incision, either periareolar or inframammary, does not appear to have a signficant effect on nipple sensitivity following breast augmentation.  Mofid et al. evaluated nipple sensitivity after breast augmentation and found no significant difference in sensation with either approach.  However, both approaches were associated with a significant change in sensation when compared to unoperated control patients.   A surgeon’s technique may contribute to sensation loss following breast augmentation.  Anecdotal evidence suggests that surgeons who use less sharp dissection in the outer portion of the breast pocket may have patients that experience less sensation loss.  While there is no study that I know of that can substantiate this, it makes anatomic sense.  The path of a portion of the nerves that supply sensation to the breast are not cut, and hopefully, are only stretched.  This potentially allows for improved recovery in comparison to nerves that are completely transected.  Recovery seems to reach its maximum at 3 to 6 months following surgery.  Beyond this time point, patients were unlikely to enjoy further recovery of sensation.  This study also implicates implant size as a controllable risk factor that impacts sensation.  Data support that there is an inverse linear correlation between implant volume and sensation outcomes.  That is, patients who choose to use larger implants relative to a smaller or tighter breast envelope will be at greater risk for sensation loss.  This was particularly true for implants larger than 475 cc.  Therefore, if you would like the greatest chance of preserving nipple sensation, select an implant with the help of your surgeon that is appropriate for your soft tissue characteristics. 

Our websites www.beauty-surgeon.com and www.drmckane.com have additional information and before and after photographs of breast augmentation.  I invite you to schedule a consultation with me if you would like to learn more about breast augmentation.  Please feel free to contact our office at (713) 661-5255 if you have any questions.

-Brice W. McKane, M.D.

© 2008 – 2009, Dr. McKane. All rights reserved.