Breast Augmentation Incision Concern

Which type of breast augmentation incision is least likely to cause loss of sensation of the nipples?

Doctor Answers 5

Different Incisions

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There is not a perfect answer for this. There are surgeons like my self who will claim that the incision will not necessarily affect nipple sensation, as it is the surgery itself. This is some what controversial and to be absolutely certain to not lose nipple sensation then you should not have the surgery.

The risk of sensation loss is very low but it is not zero for either approach, inframammary or periareolar incision.

Good luck.

Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Numb nipple

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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. The Peri-areolar incision is associated with increased risk of nipple numbness due to the fact that the nerve is in close proximity.
Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Loss of nipple sensation more likely related to size of implant and NOT incision choice.

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It is my impression from my reading that while the periareolar incision sounds as if it would have a greater risk of comprimising nipple sensation, recent reports have linked the risl of losing sensation to the relative size of the implant.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Nipple numbness after breast augmentation

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There are several components which can be involved in nipple numbness. The inframammary incision, being farther away from the nipple, is unlikely to cause nipple numbness onto itself. If, however, extensive dissection is performed to create the pocket for the breast implant, it is possible that this dissection can cause nipple numbness itself.

I perform lateral pocket dissection with a blunt technique in order to maintain the nerves that come from between the ribs to the nipple at the lateral aspects of the breast. I have a very low incidence of nipple numbness postoperatively. I think this is because of my preference for the inframammary approach and the careful dissection that I perform when creating the pocket.

You should ask your surgeon his or her thoughts about the subject before having surgery and get his or her opinion about the best way to go about about achieving you her goals.

Decreased sensation is possible with each

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You will hear different answers from different plastic surgeons. I perform a lot of inframammary fold approaches and I have a low incidence of sensation changes. In the patients whom I use incisions around the areola, I tell them I believe there is an increased chance of decreased sensation and possibly an increased incidence of a decreased ability to breast feed in the future as well. As long as you chose a board-certified plastic surgeon to care for you, you have the best chance of a result you are happy with. Best of luck.

Dr Edwards

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.