Free nipple grafting and sensation
From what you described, it sounds like you are having a free nipple graft breast reduction. After this procedure, you will not be able to breast feed and it is unlikely for you to have erogenous sensation in your nipples. You may not have any sensation at all. Some people do get back deep pressure sensation.
Free nipple graft means numb nipple
If you are having a free nipple graft, you will have numb nipples because the nerves are completely severed. They also will not react to cold or stimulation. Even with your measurements, I wouldn't jump straight to a free nipple graft procedure. I would do an inferior pedicle technique and see how the blood supply looks during surgery. At least that way, I would know we've given you every chance to keep your nipples intact.
How is nipple sensitivity after breast reduction?
Hello! Thank you for your question! With that large of a breast reduction that it sounds like you will have, it is not uncommon to have some changes in your sensation. Consideration for a free nipple graft should be discussed. Breast procedures such as the
breast augmentation and breast lift/reduction certainly result in a more
perky, and fuller appearance of your breasts. With any breast procedure
there is a risk, albeit very small, of change in
sensation to the area. The reported rate of sensation changes
(decreased, loss, or increased) is ~7% for lift/reductions and much
smaller for breast augmentation. In my experience, this rate is
reportedly much lower, but is higher when tissue is excised or the
amount of lift that is needed, so the breast reduction procedure has a
slightly greater risk. It can take up to a year for full sensation to return.
It is one risk of such a procedure, and
one that you must consider, amongst others, as with any surgical
procedure. You should consult with a plastic surgeon well-trained in
breast procedures who will examine and discuss with you the various
risks and benefits of the procedure(s) and assist you in deciding if
such a procedure will be the right decision for you.
Nipple Sensation Following Breast Reduction Surgery
The breast reduction
technique that you describe is utilized for extremely large breasts with severe
breast sag. This procedure involves totally removing the nipple areola
complexes and replacing them as free skin grafts. Unfortunately when this
procedure is utilized the nerves are divided and the nipple no longer has
reduction techniques leave the nipple areola complexes attached to the
underlying breast tissue. In women with significant breast sag, this can put
the blood supply to the nipple areola at risk and potentially cause tissue
If you’re concerned
about nipple sensation, it’s important to discuss this issue with your plastic
surgeon. Depending on your anatomy, tolerance for risk and aesthetic goals,
your surgeon may have some latitude regarding the choice of breast reduction
technique used. Another approach may be possible that preserves nipple areola
sensation and ultimately meets your aesthetic goals.
How is Nipple Sensitivity After Breast Reduction
After a routine breast reduction nerve sensation returns to normal but is sometimes delayed. If your breasts are extremely large then a nipple amputation must be performed and the nipple areolar complex will have to be reattached to the reduced breast at the correct location as a free nipple graft. These usually heal well but the sensory nerves are cut so there will be no sensation. However, patients have reported that they have some nipple erection with sympathetic stimuli.
Nipple Sensation after Breast Reduction?
Thank you for the question.
Some patients require “free nipple grafting” when undergoing breast reduction surgery. These patients generally have very large breasts and a long distance from the sternal notch to the current nipple areola position. Patients who require nipple/ areola grafting will not have any sensation after surgery. These patients are generally pleased with the results of the surgery nevertheless given the relief of symptoms ( at least partial) after the breast reduction surgery.
Most patients undergoing breast reduction surgery however do not require free nipple grafting; the majority of these patients will have normal sensation of the nipple/areola after surgery.
Nipple sensation after breast reduction
If you are planning to have a free nipple graft with your breast reduction, then you may lose your sensation. However, not all breast reductions require the complete removal of your nipple (free nipple graft). The technique used will often times determine the chances of losing nipple sensation, which generally is in the 10% range. If your breasts are extremely large and your surgeon is concerned about the blood supply to the nipple/areola then a free nipple graft offers the best chance at preserving the nipple, but not necessarily it's sensation.
If you are unsure about this issue, please ask your surgeon to review the technique again with you so you have a better understanding of the surgical plan.
Nipple sensation after breast reduction
Patients today have many excellent choices in breast reduction surgery. The amount of nipple sensation after surgery depends on the surgical technique that was used. In our practice we almost never remove the nipple from the underlying tissue. This is so that we can preserve the structures of the nipple and the sensitivity. If you are going to receive a surgery where the nipple is completely removed and then placed as a free nipple graft onto the new breast, you will lose almost all sensation to the nipple. After your healing process, you may have minimal sensation to touch in this area.
Be sure that you're working with a board-certified plastic surgeon who has a great deal of experience with breast reduction techniques. Ask your surgeon of the multiple techniques that may be used for your surgery in which technique may prevent removing the nipple in the first place.
Nipple sensitivity after breast reduction depends on how tissue is removed
For many years it was thought that loss of sensitivity depended on how much weight was removed from the breasts. However, more recently, researchers have linked postoperative nipple sensitivity with the surgical technique used. A 2005 study compared five different breast reduction techniques and revealed that removing tissue from the base of the breast leads to significantly lower postoperative nipple and areola sensitivity. In fact, the only people who ended up with completely insensitive nipples were those who underwent this type of surgery, and it occurred 48% of the time.
Schlenz I, Rigel S, Schemper M, Kuzbari R. Alteration of Nipple and Areola Sensitivity by Reduction Mammaplasty: A Prospective Comparison of Five Techniques. Plast Reconstr Surg. 2005;115(3):743-751.
Your nipple sensitivity may be reduced now as you have described a 43cm length. Often the nerves can stretch at that length. You will not have the same sensation, as well as the shape will be flatter. However, the weight relief and shape change will be tremendous and well worth any nipple change. Enjoy your soon to be new wardrobe!