Numb Breasts After Implant Exchange
Thank you for your question. As others have said it is very common to have some numbness after excision of a Baker 4 Capsular Contracture and Breast Implant Exchange.
There is usually some return of sensation by 6 months however nerves recover very slowly and can take up to 2 years.
However you describe a rather profound complete numbness and if the entire breast and nipple is numb you may not recover sensation.
Be sure to discuss your concerns with your doctor.
Loss of sensation can be transient.
Although removal and
replacement of breast implants is a relatively safe operative procedure,
occasionally complications can occur.Loss of sensation is a recognized complication of breast augmentation
and can occur in about 5% of patients.Loss of sensation may involve the breast skin or in more serious cases,
the actual nipple areola complex.In the
vast majority of cases, it’s a transient phenomena that resolves with time but
in some cases it may be permanent.
The problem seems to occur more frequently when larger
implants are used.This tends to stretch
the nerves and compress them as well resulting in loss of sensation.It’s important that you discuss this issue
thoroughly with your plastic surgeon.Although
relatively rare, there’s no question that loss of nipple areola sensation can
potentially occur with this procedure.
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.
Pablo Prichard, MD
Numbness after breast implant exchange?
Hello! Thank you for your question! Numbness after any surgical
procedure is expected for several weeks to months following. As the
nerves to the area are traumatized and will then experience a temporary
neuropraxia, a transient loss of nerve conduction. This usually
resolves over the next 6-12 weeks, but depending on the procedure
performed, sometimes much longer. Typically this should resolve by 1
year. As it goes past this date, the likelihood of the sensation
returning is small. However, it can take up to 2 years. If no return
from there, it is unlikely to return. It should be discussed that
persistent sensory changes may develop following any surgical
The usual signs of the nerves regenerating and neuropraxia
resolving is itching, followed by a burning sensation and then
occasional sharp, shock-like pains. These will be normal to experience,
and actually a promising sign. Usually, normal sensation returns, but
is is also possible to have decreased sensation or even increased
sensation to the areas affected. Re-educating nerves postoperatively is
often helpful and will allow proper instruction for the affected
sensory nerves - methods include using different textures to the
affected areas when showering, bathing, applying lotion, etc. If
bothersome, there are some medications that may be helpful, including
Neurontin for pain for hypersensitivity. You can try various textures
such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is
also beneficial for the incision to make the finest scar possible. The
last place to regain the sensation will be directly adjacent to the
incision/scar as the nerves will make its way from the periphery to this
location. If continual pain arises, evaluation is warranted. After
ruling out other causes, one rare explanation may be that a neuroma has
developed and may require surgical excision. This is very unlikely
unless a large sensory nerve has been transected inadvertently during
the procedure. Hope that this helps! Best wishes!
Numbness is common after surgery. Give yourself some time to recover, 6 weeks may feel like a long time but I would say give yourself about 6 months before concluding that there is nerve damage. Talk with your plastic surgeon about your recovery process and if you have concerns about feeling, bring them up at your follow up appointments.
Numbness after capsulectomy and breast implant replacement is almost always temporary.
The nerves to your breast get stretched during capsulectomy and implant replacement. They are not severed so sensibility should return with time. It may take as long as 6 months so be patient.
Feeling and numbness after breast surgery
Capsulectomy is a procedure wherein the entire capsule is removed from the breast. It does not seem like you had a simple implant exchange. Depending on the severity of your condition and whether or not the nerves where encountered during the capsule removal, it may take up to 6 months to determine whether you will regain sensation.
Numbness after breast implant exchange may or may not be permanent
The surgery you had is quite tricky--to remove the capsule, yet preserve enough tissue to support the nipple complex can be very difficult. The nerves that feed the breast skin aren't big enough for us to see as we are working, so they are definitely sacrificed to some degree when you have the type of surgery you had. There is nothing to do for the numbness except to give it time--it can take 18-24 months for nerves to heal themselves. If you have ANY feeling at all, that's a good sign for recovery. Also, if you experience any "lightning-bolt" sensations, that's also a good sign for recovery.
Breast numbness following Implant exchange
The nerves which provide sensation to the breasts travel along the chest wall then up through the breast tissue to the overlying skin. If you had implants on top of the muscle, it is entirely possible that the nerves were close to the contracture scars and may have been removed when the scars were removed. If that was the case, it is unlikely that all the sensation will return. However, there is plenty of cross-over among the sensory nerves and often times some degree of sensation returns over time. If the implants were under the muscle, it is still possible to have some disruption of breast sensation, albeit much less likely.
Regardless, it is common to have some disruption of sensation following breast surgery, particularly with removal of previous implant capsules as you did. It can take many months for sensation to return. Unfortunately, there is not much you can do but allow for time.
The scar tissue around your implant can involve the nerves as well. When treating your problem, the removal of the scar may involve the nerves as well. If that is the case, then complete recovery is unlikely. More likely is that the trauma and pulling made the numbeness a temprorary problem. Give it time, especially since there is no foloow-up treatment.