I am looking for a breast reduction and want to reduce the chances of losing nipple sensation

Question

My biggest fear is loss of nipple sensation. I did some research and came across studies (https://www.ncbi.nlm.nih.gov/pubmed/29213346 and ) that said there are techniques that minimize, if not eliminate, the chances of loss of sensation by avoiding a specific nerve. I would strongly prefer to go to someone well versed in those techniques who has had success with this and realizes that most women do not want to lose this. I am based in the Bay Area CA, but am willing to travel.

James N. Romanelli, MD, FACS · Answer

Even though no plastic surgeon should ever guarantee that you'll maintain nipple sensitivity following breast reduction surgery, the fact is that it's a fairly rare complication. As you can see from RealSelf's "worth it" ratings, more than 95% of breast reduction patients are happy with their outcomes. I recommend that you discuss your concerns when you consult with plastic surgeons you might select.

Jaime Perez, MD · Answer

Hello,Thank you for your question.Breast reduction surgery enjoys the highest patient satisfaction rate in all of plastic surgery. Up to 97% of breast reduction patients report improvement in preoperative symptoms and over 90% of patients report being extremely satisfied with their outcomes.Despite this extraordinarily high patient satisfaction rate, breast reduction surgery does carry its own set of risks and known complications. The most common untoward effect of beast reduction surgery is altered nipple sensation postoperatively. Up to 25% of patients report decreased sensation, changes in sensation, and occasionally increased sensation. Wound healing problems, particularly with the anchor or inverted-T breast reduction pattern are encountered in up to 20% of patients. Thankfully, almost all wounds following a breast reduction can be treated in the clinic and rarely require a return trip to the operating room. Partial or complete loss of the nipple-areolar complex occurs in 4-7% of patients undergoing breast reduction and is more common in smokers and those with a very large preoperative breast volume or length. Unsightly scarring occurs in up to 4% of patients and is more common in patients with dark skin, smokers, and those undergoing the anchor or inverted-T breast reduction technique.The ability to breast-feed is a common concern amongst women considering a breast reduction. While studies differ in their findings, it is generally accepted that most (at least 75%) if not nearly all women will have the ability to breast feed following a breast reduction, but the majority of women may need to supplement feedings with formula. The exception, however, is that women who have undergone a free nipple grafting breast reduction will be unable to breast feed as the connection between their nipple and milk ducts has been severed. Fortunately, women electing for a free nipple grafting breast reduction are usually past childbearing age and are not concerned about their inability to breast-feed.Additional considerations following a breast reduction include the possibility of postoperative breast asymmetry, bleeding, infection, insufficient reduction, over-reduction, and change in breast shape over time. We examine all of patients within one to two days after surgery so that in the rare chance there is a complication, it can be diagnosed and addressed appropriately.

John Michael Thomassen, MD · Answer

Most surgeons perform the procedure described in the illustration commonly referred to as a Wise pattern technique.  Along with this technique, the superomedial pedicle for the nipple/areola has the best chance of sparing sensory innervation to the nipple.  You should not need to travel too far to find surgeons that will perform this procedure for you.

Daniel Barrett, MD · Answer

Dear jessrealreal,Finding the right Dr. is extremely challenging especially with the number of online platforms and resources available. There a lot of great Dr's available. Definitely check to make sure your choice specializes in the procedure you want and spend the time to read through patient testimonials. 
You can always pick up the phone and call around also, find an office you feel comfortable with and set up a few consultations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Robert Drielsma, MBBS, BSc, FRACS · Answer

You have raised a very important question.  No surgeon can guarantee that you won’t experience loss of nipple sensation after breast reduction surgery.  You can decrease the risk by using a fully qualified and experienced plastic surgeon with extensive experience in breast reduction surgery.

I am looking for a breast reduction and want to reduce the chances of losing nipple sensation

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I am looking for a breast reduction and want to reduce the chances of losing nipple sensation

Answers (8)

Answer: Breast reduction

Answer: Breast reduction

Answer: Nipple sensitivity after breast reduction

Answer: Nipple sensitivity after breast reduction

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Everything you need to know about Breast Reduction

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