The surgical techniques used in breast augmentation have been refined over the years to provide patients with beautiful cosmetic results that look and feel natural. With the range of breast implants available today, getting a natural look is a matter of choosing the right size and type of implant that best suits the patient’s overall body type. Nipple and skin sensation is a different story.
Most women do experience a change in sensation in one or both of the nipples and in the skin just under the breast. This begins with hypersensitivity or numbness in the nipples and numbness in the skin. Most patients find that sensation returns to normal within 2 to 4 months depending on where the implant was inserted.
IMPLANT PLACEMENT IS KEY
There are four areas that can be used as insertion points; the inframammary fold just under the breast, the armpit, the belly button and the nipple area. These choices are generally made based on masking the resulting scar. There are also choices on where the implant will be placed, either under the muscle or closer to the surface, just under the mammary gland structure.
Preserving sensation in the nipple complex is very important and to ensure the complete success in breast augmentation. There have been many opinions offered on why some women experience permanent loss of sensation in the nipple. Very large implants that stretch the nipple and skin are thought to be a factor as the nerves also need to stretch while adjusting.
RESULTS OF A 6 YEAR CLINICAL STUDY ON NIPPLE SENSATION AND PAIN
A study on the subject of nipple sensation and pain following primary breast augmentation was conducted over a 6 year period in Rome and the UK with over 1200 cases. The findings were released in 2011 reporting that implant size and implant placement – either above or below the muscle – had no bearing on nipple sensation and pain. The main factor that caused problems with nipple sensitivity or numbness was placing the implant through an incision at the edge the areola. This ‘periareolar’ incision was found to increase changes in nipple sensation and pain by a factor of three when patients were assessed six months after surgery.
The reason for diminished sensation is thought to be caused by cutting the nerves that support the nipple-areola complex. Scar tissue may also block regeneration of nerve channels following periareolar incision.
CHANGES IN NIPPLE SENSATION
In up to 6% of patients, there will be some change in nipple sensation following breast augmentation. The degree of change will vary from patient to patient with most patients finding that nipple sensitivity returns to normal range once all healing has occurred.
Discussion of this potential change should be part of every woman’s relationship with her plastic surgeon. Avoiding sensitivity problems can be done by choosing an implant that is not overly large and using the fold under the breast called the inframammary fold, as an insertion point.
While all women experience some degree of sensitivity or numbness following breast augmentation surgery, the vast majority of patients find that after a few months their sensitivity problems are resolved leaving them free to fully enjoy their enhanced feminine appearance.