Nipple sensation is usually carried to the brain via the lateral 4th intercostal nerve, and sometimes via branches of the 3rd or 5th. These nerve branches are tiny fibers, usually not visible, and even if they are, often indistinguishable from other fibers or vessels. In short, they aren't color-coded, nor are they waving flags that say "Save me, save me!" Thus, careful surgery (or not) essentially has no impact on whether these are damaged (or not). Then, of course, is the type or severity of nerve damage. If the nerve(s) are cut, they're not able to heal back together, and permanent numbness results. This occurs in around 5% of breast implant patients, and around 15% of breast lift or reduction patients. BA plus lift together is still around 15%.However, if the nerve branch(es) are stretched, bruised, or only partially injured, they can indeed heal over time. 6-12 months is usually necessary, but if you don't have some sensory return by a year post-op, it's likely to be permanent. I've seen changes up to 2 years, but it's minimally different, and really rare anyway.So, I check nipple sensation right after surgery. If some sensation is intact (any sensation at all), then time and healing will usually mean the nipple-to-brain connection is preserved and will recover. Quality of sensation might be altered, but usually not once maximum healing is reached. This is both "touch" and erotic sensation, so that's good news! If a patient has numbness (complete or so near-complete it's impossible to differentiate), then I tell them they could be in the 15% with permanent numbness, or the 85% where recovery will be seen by up to one year post-op. OK news, usually. I hope that helps! Dr. Tholen