What Kind of Breast Lift (With Implants) Carries the Lowest Risk of Nipple Sensation Loss?

I almost certainly need a breast lift with implants after losing about 115lbs, however, I'm TERRIFIED of losing sensation. I rather enjoy having it, if you know what I mean. ;) .... And to me, what is the point of having perfect breasts that do not -work- ? I'm only mildly worried about scarring, that's not the major issue here. So what incision styles (crescent, benelli, anchor, etc) carry the lowest risk of sensation loss? Am I correct in assuming that fewer cuts would be less risky?

Doctor Answers (14)

Nipple sensitivity risks?

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Dear PA,
Thank you for your post. In general, most women who have a disturbance in nipple sensation, whether it be less (hypo-sensation), or in some cases too much (hyper-sensation), the sensation goes back to normal with 3-6 months. Occasionally, it can take 1 - 2 years to be normal. Extremely rare, the sensation never goes back to normal. This is extremely rare in augmentation alone, more common in lift or reduction but less with a smaller lift like a crescent lift. Signs that sensation is coming back are needle type sensation at the nipple, itchiness at the nipple, or 'zingers' to the nipple. The number of women that lose sensation is much lower than 10%, closer to 1% in a simple augmentation. In some cases the same occurs with contraction where some women have no contraction and some women have a constant contraction of the nipples. Unfortunately there is no surgical correction for this. Massaging the area can help sensation normalize faster if it is going to normalize, but will not help if the nerve does not recover. In women with hyper-sensitive nipples, this will go away with time in most cases. Usually 3 months or so. In the interim, I have them wear nipple covers or 'pasties' to protect them from rubbing. It is unlikely that down-sizing the implant will cause regaining sensation. Down-sizing the implant may cause saggy breasts, however, and may necessitate a breast lift. Physical therapy with de-sensitivity techniques can help with this issue.
Best Wishes,
Pablo Prichard, MD


Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

What kind of breast lift (with implants) carries the lowest risk of nipple sensation loss?

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Hello! Thank you for your question! Breast procedures such as the breast lift and breast reduction certainly result in a more shapely, perky, and fuller appearance of your breasts along with raising of the nipple-areolar complex to an appropriate position. Since there is an incision made around the areola along with some rearrangement of tissue of the breast, there is a risk, albeit very small, of change in sensation to the area. The reported rate of sensation changes (decreased, loss, or increased) is ~7%. In my experience, this rate is reportedly much lower, but is higher when tissue is excised or the amount of lift that is needed, so the breast reduction procedure has a slightly greater risk.  Certainly the larger the lift/incisions, the greater the risk of change in sensation.

It is one risk of such a procedure, and one that you must consider, amongst others, as with any surgical procedure. You should consult with a plastic surgeon well-trained in breast procedures who will examine and discuss with you the various risks and benefits of the procedure(s) and assist you in deciding if such a procedure will be the right decision for you.

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Nipple sensation

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All breast lift require some relocation of the nipple areolar complex. All lift cannot be performed on every breast as they each have limitations. Loss of nipple sensation rarely occurs on any lift that is not a accompanied by a significant breast reduction. Therefore I suggest youy get the lift that would provide the best result based on your goals if they are realistic.

Howard N. Robinson, MD
Miami Plastic Surgeon
4.5 out of 5 stars 36 reviews

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Breast lift techniques and nipple sensation.

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The sensation to the nipple comes from nerve fibers running over the pectoralis then extending upwards into the breast. Anatomy varies from person to person, but in general a lift which preserves the central breast mound is most likely to preserve sensation. However, as with any surgical breast procedure, nipple sensation loss is a possible complication and if this is an unacceptable risk, then avoiding surgery is a better option.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

What Kind of Breast Lift (With Implants) Carries the Lowest Risk of Nipple Sensation Loss?

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If it is only a breast lift that you need and not a reduction mammoplasty, the best method to preserve nipple sensation is what we call a "central pedical flap." This techniques keeps the nipple attached to the underlying breast tissue and nerve supply and only the surrounding skin is dissected and resected. I have never seen nipple sensation loss with this technique after using it for several decades. However, you are limited in how far you can lift the nipple-areolar complex. On the other hand, this is virtually the only technique that I use, so with rare exceptions, it can be used in most cases.

With any breast surgery, even a breast augmentation, there can be some initial sensation changes, so do not let the first few weeks scare you into thinking it is permanent.

Good luck with your procedure. Excellent question.

E. Ronald Finger, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 36 reviews

Nipple sensory loss after breast lifts

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I can only say what is in the literature for breast reductions. The one that provides the best sensation and ability to breast feed is considered the inferior pedicle technique,. However a lift often requires less dissection of tissues, so it depends upon a number of factors.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Breast Reduction and Nipple sensation

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Hi

Your concerns and very valid and relevant, the trouble is that it is very difficult to predict what technique results in the most nipple sensory change.

One thing is for sure it is the glandular pedicle used that governs the likely postoperative nipple sensation and not the skin incisions used. Here is a short abstract of a paper that may help shed some light on your concerns:

Schlenz, et al, Alteration of Nipple and Areola Sensitivity by reduction Mammaplasty: A Prospective Comparison of five techniques, 115(3) PRS Journal March 2005 p. 743- 754.
• Alteration of NAC sensitivity not shown to be related to the weight of reduction but to the type of surgical technique; the anatomical location of glandular resection predicts the risk of post-op reduction of NAC sensitivity. Superior pedicle techniqes, ie resection of inferior pole, were shown to have a higher rate of altered NAC sensitivity.

 

I hope this helps and good luck

Pouria

Pouria Moradi, MBBS, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 45 reviews

Loss of Nipple Sensation

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First of all, not every patient who thinks they need a lift really needs one, so photos would be a big help to answer this question. Also, the type of lift that might work best for you cannot be determined without seeing what your anatomy is. That aside, I tell all my patients the risk of loss of sensation seems to be about the same with either an augment or a lift and that is in the 10% range for some degree of numbness. I also tell them that if the risk is unacceptable, they should avoid the surgery.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Nipple Sensation Loss #breastimplants

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Technically speaking the central mound technique would carry the least risk of numbness to the nipples. Being that said, they all are pretty close with the potential for numbness. Most of the time numbness is temporary and will resolve with time. It can take several months. There is commonly tissue swelling around the nerve that can cause this or even stretch on the nerve can lead to temporary numbness. Permanent numbness is rare and would require the surgeon to cut the nerve most likely. It is a valid concern, but for the most part patients do very well with no permanent issues.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 21 reviews

Possible Loss of Nipple Sensation with Breast Augmentation/Lift

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What I usually tell my patients is that there is always a chance of changes in nipple sensation when performing breast surgery. It does not depend on the type of implant but rather the surgery itself. The nerves that innervate the nipple can be stretched or even cut, depending on the procedure you have done. Usually the changes are temporary, but they can be permanent at times. I recommend you weigh the risks and benefits of improving the look and feel of your breasts vs. nipple sensation changes and decide which is more important to you.

Itzhak Nir, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 7 reviews

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.