Very Sensitive Nipples 3 Years After Breast Augmentation?

Thank you for your question. Hypersensitivity to the nipple or other breast regions is normal after surgery. The nerves may have been stretched and transiently down for the count. As they wake up, they want to let you know they are still there by over signalling their presence. Hence very sensitive nipples. Things typically do resolve with time. In the meantime, you can take two approaches. Compression or tape to minimize friction on the nipples. The other approach could be desensitization with over stimulation (e.g. vibration).Since this has also started years after your augmentation, I do not think it is related to the implants or the fact that they are silicone.  I would revisit with your plastic surgeon.

Hello! Thank you for your question! Your symptoms sound like your
nerves regenerating. Breast procedures such as the
breast augmentation and breast lift/reduction certainly result in a more
shapely,
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. Re-educating your nerves to these areas by using different
textures when showering and putting on lotion often helps.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.

It is unlikely your silicone implants are the direct cause of your increased nipple sensitivity but there are several issues here to be addressed. Sudden appearance of dry chaffed nipples could be a sign of a more serious underlying disease such as Paget's disease and should be evaluated by an experienced profeesional. Other causes I have observed include the possibility of nerve irritation occuring with repetitive motion such as painting a room. Also I had one patient who' sudden increase in sensitivity heralded her being pregnant. Weight gain is associated with increased tenderness.  As you can see there are many potential causes and you should see your physician for an evaluation including the possiblity of imaging or biopsy.

It is unlikely that the recent sensitivity changes you've seen are a result of your surgery.  Temparary changes after a breast augmentation are relatively common.  Some patients become more sensitive, some patients claim to be less sensitive.  Permanent sensory changes are rare.  Over the years I have seen a handful of patients who have developed similiar symptoms to yours.  For some unknown reason they developed what appeared to be a rash of one or both areolae years after surgery.  Their symptoms cleared up with a topical steroid.  Your best bet is to be evaluated by an experienced board certified plastic surgeon in your area. 

Nipple sensation can be affected by breast augmentation but this is usually in the early postoperative period.  Sensation can be decreased (more common) or increased.

The symptoms you describe with dryness, pain, and peeling do not seem to be related to the breast augmentation.  This may be due to a skin disease or sensitivity to fabrics, chemicals, or environmental exposure.

This is something that you may want to have your PCP or a dermatologist look at to determine if something can be done to help improve your symptoms.

Many women will experience an increase in the sensitivity of their nipples following breast augmentation.  But for most, this increase sensation will generally subside over time and normalize.  If you experience significant sensitivity or even pain to your nipples after the first year, there is probably something else going on.  

First, you may have a degree of capsular contracture.  However, this generally causes discomfort to the entire breast and is usually on one side only.  

Next, you may have a ruptured implant.  However, the likelihood of both rupturing at the same time is incredibly low.

Finally, this change may have nothing whatsoever to do with your implants and may be related to your native breast tissue.

To best determine what is causing this and to effectively treat it, you are best off to see a local Board Certified Plastic Surgeon in your area and have he/she examine you to rule out the obvious possible causes.  If no cause is found, then a mammogram followed by an ultrasound or MRI might also help identify a cause for your symptoms.

 

I hope this helps!

Acute changes in nipple sensation can occur after surgical breast augmentation.  However, the acute change in sensation is not typical of long term postsurgical changes and may be due to xerosis, contact irritation, or even pregnancy.  Consult with a breast specialist as soon as possible if the problem does not resolve within weeks.

It is highly doubtful that your recent onset of nipple hypersensitivity is related to your implants.  Although they are foreign bodies and there is a metabolic response to this, it almost never results in neuritis and hypersensitive nipples.  The recent onset suggests that something else is the problem, possibly a topical allergy.  I suggest you see your surgeon or possibly consult with a dermatologist.

Dear alikidd, 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. In your case, sensitivity that happens this far from surgery may be related to a capsular contraction that is affecting the nerve to the nipple. This may be able to be lessened by a capsulotomy or capsulectomy. Discuss with your PS.Best Wishes,Pablo Prichard, MD 

Problems beginning years after augmentation are almost certainly not related to the augmentation procedure.  

Minor nipple sensitivity changes are very common temporarily after breast augmentation.  However, these problems usually gone within a few months.    Please see your family physician to rule out common causes for this problem and to have a health examination.

Claudio DeLorenzi MD FRCS