Will an areola incision cause my nipples to be less sensitive?

Question

I'm curious for my future BA that an incision through my areola will cause less sensitivity in my nipples

Kenneth Hughes, MD · Answer

Nipple characteristics after the initial healing phase following breast augmentation are typically the same. A small percentage of patients have longstanding pain, numbness, or alteration in sensitivity. A small percentage of patients may lose sensation, but most of the time this is temporary. In fact, less than 5% of patients lose nipple sensitivity after breast augmentation. Some of the risk of losing sensitivity depends upon surgical technique. Areloar or periareolar incisions may increase the risk for sensation loss in the nipple compared to other incision placements.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Nipple sensation loss is always a possibility.  Yes with an areola incision the chances increase for the issue, but typically it ends up being ok.  I would suggest to see a Board Certified Plastic Surgeon in person to evaluate you and discuss your options.  Best of luck to you.

Nelson Castillo, MD · Answer

Thank you for sharing your question. All incision types may result in some temporary, or permanent, loss of sensation to breast skin or the nipple.  That said the periareolar incision does carry a slightly higher rate. Hope this helps.

Casey Anderson, MD, FACS · Answer

For the vast majority of patients, the nipple sensation will return to normal after an areola incision. If it stayed numb after surgery, nobody would have that surgery any more. It may take a couple months to become totally normal. This is a sacrifice patients are willing to make to achieve the look implants provide. As always, be sure to research who is doing your procedure to increase the chances of getting a desirable result.

Daniel Barrett, MD · Answer

Dear lovegot7_,
I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Bruce K. Smith, MD · Answer

Changes in breast or nipple sensation can happen after breast augmentation from any approach and is not limited to the periareolar approach. If you experience loss of sensation, be reassured that it is usually temporary and will return in weeks to months. In less than 1% the changes can be permanent. I have had a very few patients complain long term about loss of sensation. One or two patients have shared with me that they had lost "erotic" sensation. It is certainly a risk but realistically a very small risk considering the many benefits of the surgery.

Camille Cash, MD · Answer

Though change in sensation with breast augmentation can be permanent, it usually is not.  Those who experience sensitivity changes after surgery typically report things returning to normal after the first few months.  Swelling and trauma from surgery can be the culprit early on,  but generally improve with time.

Karan Chopra, MD · Answer

The incision does not typically have any effect. The size of the implant has the greatest effect on nipple sensation after surgery. With any modestly sized implant (less than 450 cc)  you should be fine.

Connie Hiers, MD, FACS · Answer

This is a small possibility that you could loose some or all sensation in your nipples with the periareolar incision. Most women do not.

David Mattos, MD · Answer

All incisions on the breast, and any underlying dissection done for surgery to create space for an implant, has the capability of making your nipples less sensitive. Typically any change that is appreciated is temporary. Most commonly, any sensation change that is present is felt between the nipple and the inframammary fold, not on the nipple itself. That being said, it is possible, though uncommon, for nipple sensation to be affected. Areolar incisions carry a slightly higher risk of changes to nipple sensation. 
-Dr. David Mattos, Harvard-trained plastic surgeon

Will an areola incision cause my nipples to be less sensitive?

Answers (13)

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