After breast augmentation, do the scars around the nipple cause it to be less sensitive?
I am curious to know how the scar around the nipple affects the sensitivity of the nipple after it has healed.
Doctor Answers 12
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
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
Web reference: http://www.aaaplasticsurgery.com/photo-gallery/details.cfm?ID=77&StartRow=16
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, MD
Los Angeles, CA
Kenneth Hughes, MD
Los Angeles, CA
Web reference: http://www.hughesplasticsurgery.com/breast-augmentation-photo-galleries.php
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.
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Any type of augmentation may cause a change in nipple sensation, either temporary or permanent. Usually there is no permanent loss of sensation.
You may temporarily have changes in nipple and areola sensation after a breast augmentation, Some patients actually have hypersensitivity (increase sensation) after this surgery.
Best wishes
Best wishes
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
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
Web reference: http://widderplasticsurgery.com
Thank you for your question. Normally, when periareolar breast augmentation is properly done nipple sensation remains intact.
Web reference: http://drseckel.com/surgical-procedures/result-oriented-breast-augmentation-breast-enlargement/
When the peri-areolar incision is made for breast augmentation, the sensation is usually retained, although the nipples may have some slight decreased sensitivity for a while.
This incision usually heals quite well and becomes inconspicuous over time.
However, recent trends in breast augmentation surgery have suggested that use of the infra-mammary fold incision can result in lower rates of capsular contracture and are generally a bit safer.
Best to consult with several surgeons and gather their opinions -- then go with the surgeon with whom you have the most comfort and confidence.
Good luck!
Elliot Jacobs, MD, FACS
New York City
This incision usually heals quite well and becomes inconspicuous over time.
However, recent trends in breast augmentation surgery have suggested that use of the infra-mammary fold incision can result in lower rates of capsular contracture and are generally a bit safer.
Best to consult with several surgeons and gather their opinions -- then go with the surgeon with whom you have the most comfort and confidence.
Good luck!
Elliot Jacobs, MD, FACS
New York City
There is no difference in nipple areolar sensitivity wether a peri areolar, infra mammary or trans axillary is used to augment the breast with a breast implant. There is infrequent but slightly higher chance of nipple areolar sensation decrease with the sub mammary placement of the implant as compared to the sub muscular but neither is very high. Regardless I feel that the most natural looking and feeling breast with the best scar is a peri areolar incision and a sub mammary placement of a textured gel breast implant. The only problem with this approach is when a woman has very thin breast tissue in the upper poll of her breast and in that case because of the risk of seeing or feeling the the ripples that are present in all breast implant, I recommend a dual plane approach. The incision is still in the peri areolar location, the inferior part of the breast is elevated down to the infra mammary crease and then the pectoralis muscle is elevated and the implant is placed below the breast in the bottom half and behind the muscle in the upper half.
The incision used to perform breast augmentation surgery does not necessarily affect nipple/areola complex sensation. The more likely cause of decreased or loss of sensation is injury to the intercostal nerves.
Web reference: http://www.poustiplasticsurgery.com/Procedures/Procedure_breastAugmentation.htm
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.
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