What kind of sensation can be expected to return to the newly reconstructed area following breast reconstruction surgery?
Does a Reconstructed Breast Feel Different?
Doctor Answers (8)
Sensation after Mastectomy & Breast Reconstruction
Most patients have some sensation after breast reconstruction, but the majority of the fine tactile sensation is lost as the nerves are cut during the mastectomy or removal of breast tissue.
Sensation with breast reconstruction
Usually if a pedicled or free flap is performed for breast reconstruction, it is insensate or only sensitive to deep pressure.
Sensation in Your Breasts after Mastectomy
Unfortunately, during a mastectomy, the nerves to your breast skin, and if a nipple-sparing mastectomy is done, to your nipple, are necessarily divided. As a result, sensation in the skin of your breast that remains after surgery (and nipple, if it is preserved) is significantly reduced and can even be completely lost. If a woman undergoes reconstruction with her own tissue (autologous reconstruction), some of the nerve endings that were cut during the mastectomy my grow back into the reconstructed breast and a "low level" of sensation to the reconstructed breast. By contrast, nerves cannot grow into breast implants.
If a free flap, such as a DIEP flap, is used for breast reconstruction, your surgeon may be able to connect nerves in the flap to nerves at the mastectomy site and enhance the degree of sensation that returns to a reconstructed breast.
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Skin sensation after breast reconstruction
Sensation to the nipple and areola depends on whether you have undergone a nipple sparing mastectomy, lumpectomy, or full mastectomy. Breast reconstruction will not have the same nerve sensation as the native nipple and breast tissue.
Sensation after Breast Reconstruction
After a mastectomy, the nerves to the skin that remains are gone. This creates a large area of numbness in the mastectomy flaps. Over time, many women regain partial sensation which is thought to be due to recruitment of nerve fibers from the peripheral skin. However, this improvement does not return to pre-surgical levels. Regardless of reconstruction type (implant, TRAM, Latissimus, DIEP) this lack of sensation prevails.
The skin will maintain some sensation after breast reconstruction
When a breast is removed during a mastectomy, the main sensory nerve supply is removed along with the nipple and areola. The remaining skin will still have some sensation, but not to the same degree as before the mastectomy. Although breast reconstruction is great at recreating the shape of a breast, the sensory nerve supply cannot be reestablished.
The numbness is from the breast removal surgery
Breasts are numb after mastectomy. The reason is that removal of the breast includes the nerves that provide that sensation. Breast reconstruction does not replace this lost sensation to any good extent anyway. A "crude pressure feeling" is commonly all that a patient gets whether or not reconstruction has followed mastectomy.
Numbness likely after mastectomy with or without reconstruction
Dear Sandy: I'm sorry to hear you're facing breast cancer and its treatment. However, treatment is more successful now than in the past, including reconstruction.
As far as breast sensation you should discuss with your tumor surgeon and plastic surgeon their experiences with the types of surgery they recommend. Generally, if a standard mastectomy is done, then sensory nerves that go through your body, including the breast tissue itself are removed with the breast. The thinner overlying skin will contain few nerves to provide very limited feeling.
Reconstructive surgery to provide breast shape and appearance will not re-establish sensation. Given all of this, we are still pleased when an occasional patient tells us she is beginning to have feeling months or years after reconstruction. Best wishes.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.