Breast reduction surgery can change how your nipples feel. If the nipple nerves are disrupted during surgery, you might lose some or all of the feeling in your nipples. This sensation usually comes back, but for some people, it’s lost for good.
A skilled surgeon may be able to protect the nipple functions during surgery and maximize the chances of getting back nipple sensation after breast reduction.
Dr. Craig Rubinstein is an experienced breast plastic surgeon in Australia. He provides his patients with breast reduction options such as anchor, vertical, donut, no vertical scar, and liposuction procedures. With his experience in advanced pedicle techniques, Dr. Rubinstein protects nipple sensation while aiming for an optimal outcome of your breast reduction surgery.
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How Does Breast Reduction Surgery Affect Nipple Sensation?
Breast reduction surgery, also known as reduction mammoplasty, is a cosmetic surgery that reduces the size of excessively heavy breasts.
Each of your nipples has a lot of nerve endings that make them sensitive to touch and other stimuli. The nerves supplying your nipples pass through the deep layers of your breast tissue and are more superficial in the nipple area.
When the nerves supplying your nipples are cut or disrupted, you may lose some or all of the sensation in your nipples. During a breast reduction, this could happen because:
- A significant amount of breast tissue is removed to make the breasts smaller. While the excess breast tissue is being removed, some of the nerves may be cut. As a result, the nerve supply to the nipple could become disrupted.
- The surgery also involves the repositioning of the nipples and the areola (pigmented skin around the nipple). To do that, an incision around the areola is done which can also disrupt the small branches of nipple nerves.
- As with any other surgery, swelling is a normal part of the healing process. The swelling in your breast after reduction mammaplasty could add pressure on the nipple nerves and interfere with their function.
Therefore, as you’re healing from breast reduction surgery, you may notice that your nipples are feeling numb or that they’re not as sensitive as they used to be. This is common in the early weeks after your surgery. Nonetheless, losing nipple sensation after reduction mammoplasty is usually temporary.
Not all patients experience a decreased nipple sensitivity after reducing their breasts. Some patients don’t feel a change at all in how their nipples feel. The nipples might even become hypersensitive (having increased sensation). This also settles down with time.
Timeline of Nipple Sensation Recovery
The time it takes to regain normal feeling in the nipple depends on your body anatomy and the specific surgical technique used during your reduction surgery. But nipple sensation usually returns to normal with time.
As the swelling from your mammoplasty subsides, the nerves slowly start getting back their ability to function normally. In most cases, the numbness goes away and the feeling in the nipple returns to normal 2-3 months after breast reduction surgery.
On the other hand, if the nipple nerves were cut, new nerves have to grow to restore nipple sensation. This usually takes between 6 months to a year. In other patients, it can take up to 2 years before normal nipple sensation is restored.
As the nerves grow back, you might experience some itching, tingling, or an intermittent “shooting” sensation around your nipples.
There’s a small possibility that you will permanently lose normal feeling in your nipples after your reduction mammoplasty.
What are the Chances of Losing Nipple Sensation After Breast Reduction?
It’s very common to notice changes in the nipple sensitivity and sensations for a while after reducing the breasts with surgery. One out of 3 patients reports temporary loss of nipple sensation following their reduction mammoplasty.
Although nipple sensation almost always returns to normal with time, there’s a chance of permanently losing sensation in the nipples after breast reduction surgery.
35% of the patients who got their breasts reduced using the inverted-T technique reported persistent nipple numbness even 2 years after their surgery. Meanwhile, the risk of permanent nipple numbness was 21.5% after a vertical breast reduction.
On the contrary, some patients with very large breasts or excessive sagging report that they have little breast sensation, to begin with. That’s because the excess breast tissue can stretch the nerves of the nipples and reduce their function. Consequently, some of these patients gain more nipple sensation after their breast reduction.
As long as good surgical techniques are used, the risk of permanent loss of nipple sensation can be minimized.
Techniques to Preserve Nipple Sensation During Breast Reduction
Whether you’re getting a breast augmentation, breast lift (mastopexy), or a breast reduction, there is a chance you might lose some of your nipples’ sensitivity. However, that can be avoided with suitable breast reduction options and proper surgical techniques.
Breast reduction options
Dr. Rubinstein will determine an appropriate breast reduction option depending on your anatomy, the size of your breasts, and the amount of ptosis you have. After careful assessment, you may receive:
- Anchor breast reduction (Inverted-T): This is the most common breast reduction procedure for women with extremely large and breasts with ptosis. Through an anchor-shaped incision, a large amount of excess breast tissue is removed.
- Vertical breast reduction (lollipop): Using an incision in the shape of a “lollipop”, a considerable amount of breast tissue is removed from all layers of the breast. This is also a very popular option among women with mild to moderate breast ptosis.
- Donut breast reduction (Benelli): This option is more suitable for patients with only mildly large breasts who don’t need a lot of breast tissue removal.
- No vertical scar breast reduction: If you have severe breast drooping but don’t want a vertical scar on your breasts, this breast reduction option might be suitable for you.
During your reduction mammoplasty, Dr. Rubinstein will reduce the size of your breasts. He will use his surgical experience and detailed knowledge of breast anatomy to:
- Carefully dissect the breast tissue and avoid injuring nipple nerves during your breast reduction
- Make precise incisions away from any large nerve supplies to preserve nipple sensation during breast reduction surgery
- Attentively dissect the breast layer by layer to remove as much tissue as possible while steering clear from major innervation to the breast
- Use antiseptic surgical techniques to avoid any bacterial growth and infections that can compromise the results of your breast reduction and interfere with your healing leading to loss of nipple sensitivity in the future
- Strategically close your wounds layer by layer and keep the breast tissue adjacent to each other. This will help him restore the normal anatomy of your breast as much as possible, help your healing process, and increase your chances of regaining nipple sensation after reducing your breasts
For patients with minimal ptosis and not a lot of extra breast tissue, liposuction in an option for breast reduction.
Breast liposuction is a minimally invasive technique that leaves small scars. Using fat lipo, the size of the breast can be reduced with very minimal to no sensation loss in the nipple in most cases.
Advanced techniques to preserve nipple sensation
Cutting the nipple and the areola during breast reduction compromises the nerves and decreases your chances of regaining nipple sensation after your recovery. Instead, Dr. Rubinstein uses pedicle reduction techniques to give his patients the best chance of getting back feeling in the nipples after surgery.
During a pedicle breast reduction:
- The nipple remains attached to the breast during surgery to spare as many nerves as possible
- Meanwhile, a tissue graft (pedicle) with nerves and blood vessels is attached to the breast near the nipple
- The pedicle provides a blood supply to the nipple-areola complex while breast tissue is removed
As long the nipple-areola complex remains attached and receives a blood supply, there’s a higher chance that the nipple sensation will return over the months following your breast reduction surgery.
Depending on the size and shape of the breasts, Dr. Rubinstein commonly performs:
- Inferior pedicle reduction: The pedicle graft is placed beneath (inferior) the nipple-areola complex. This gives the nipple a generous blood supply and protects its functions during surgery.
- Vertical (superomedial) breast reduction: This is the preferred technique for smaller breast reductions. A pedicle is placed above the nipple and a little towards the side (superomedial). It gives the nipple-areola complex an excellent blood supply while Dr. Rubinstein easily removes excess breast tissue. The superomedial pedicle reduces the risk of blood supply problems and preserves nipple sensation during reduction mammoplasty.
Dr. Rubinstein commonly performs these techniques to avoid nerve loss, prevent damage, and maintain nipple sensation after reduction mammaplasty.
On the other hand, for patients with very large breasts, a free nipple reduction technique may be a more suitable option because:
- When the breasts are oversized, blood has to travel very long distances to reach the nipple
- The nipple is removed from the breast and then reattached as a skin graft to make sure it receives enough blood supply
Although this is a more drastic technique, it gives patients with very heavy breasts the best chance to regain feeling in their nipples after their breast reduction.
What is the Best Way to Avoid Risks of Breast Reduction Surgery?
Although at first glance breast reduction surgery can seem like a pretty straightforward surgery but it requires years of extensive experience. An accomplished surgeon will know how much breast tissue to remove, which surgical techniques to use, and where to make his incisions.
The journey toward the perfect breasts can be challenging but it starts with choosing the right plastic surgeon. Dr. Craig Rubinstein is experienced in breast reduction surgeries. He continuously refines his surgery techniques.
- Unfavourable results following reduction mammoplasty – PMC
- Mastopexy and Reduction Mammoplasty Pedicles and Skin Resection Patterns – PMC
- Comparison of Vertical and Inverted-T Mammaplasties Using Photographic Measurements – PMC
- Breast Reduction with Use of the Free Nipple Graft Technique | Aesthetic Surgery Journal | Oxford Academic
- Breast sensation after superior pedicle versus inferior pedicle mammaplasty: anatomical and histological evaluation
- Commentary on: Vertical Reduction Mammaplasty Utilizing the Superomedial Pedicle: Is It Really for Everyone? | Aesthetic Surgery Journal | Oxford Academic
About Dr Craig Rubinstein
Dr Craig Rubinstein FRACS (Fellow of the Royal Australasian College of Surgeons) is an experienced Melbourne Specialist Plastic Surgeon for breast and abdominoplasty surgery.
Dr Rubinstein offers women personalised abdominoplasty surgery and all forms of cosmetic breast surgery.
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