After breast augmentation, do the scars around the nipple cause it to be less sensitive?

   There are multiple factors in sensation.  The cutaneous contribution that is altered with the skin incision is very small with regard to sensation.  I perform all incisions so that patients can decide what is right for them.Kenneth Hughes, MDLos Angeles, CA

while it is true that any scar location can lead to sensation changes a nipple scar does potentially divide more nerves near the nipple and could possibly affect nerve sensation in this manner a little more than other incision options. 

Dear bresmom,The sensation to the nipples comes from intercostal nerves that course on top of the pectoralis muscle and reach the nipple vertically. So, incision under or around the areola does not impact the nipple sensation. 2 things can impact the sensation of the nipples : 1. Subglandular breasts augmentation ( above the muscle ) because that is where the nerves course after they exit from the muscle laterally and can be damaged during the dissection of the pocket. That is why nipple sensation is better maintained in the submusclar breasts augmentation procedure. 2. When the anatomy of the intercostal nerves is such that they exit the muscle too medially and can be damaged during the lateral dissection of the pocket. Always, consult with board certified plastic surgeons and check their befor and after pictures to make sure that you like the results. Also, make sure that their pictures are numerous and consistent and they have good reviews.            All the best,                                     Dr Widder

When using the peri-areolar incision for breast augmentation, very few patients have problems with loss of nipple sensitivity. This scar also usually heals quite well and can be difficult to perceive if done well. But I have stopped using this incision because I have clinical evidence to suggest that the capsular contracture rate is higher when using this incision. I strongly prefer the breast crease incision for this reason. 

Dear GDB, 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.  As far as incisions go, the peri-areolar incision is associated with about twice the incidence of nipple numbness vs. other incisions.Best Wishes,Pablo Prichard, MD