Nipple erection/ inverted nipples - how common is it to lose all nipple sensation?

The loss of nipple sensitivity following a breast lift is directly related to the surgical technique used, with central pedicle-based techniques having the lowest risk of sensitivity loss. From your description, it sounds like you're planning an explantation mastopexy procedure. In such cases, to preserve breast volume and nipple sensation, it's essential to choose a lift technique that doesn't involve tissue reduction. The Push-up Lift breast technique stands out as the most suitable option for you. With this method, nipple blood supply, sensation, and breast volume are preserved to the highest possible degree, while also effectively reshaping the breast.

There are a variety of techniques for breast lifts. One of the most common techniques is the lollipop, which often results in nipple numbness. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

a permanent decrease or loss of nipple feeling with breast lift surgery. And, equally rare to affect nipple ability to react to temperature with nipple "erection". Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

You are correct that it is impossible to give an exact prediction as to how any individual patient will respond to surgery. However, total loss of sensation of the nipple and loss of the nipple erection after a breast lift is rare. A breast lift usually only involves removal of some skin and repositioning the breast to a higher level. The sensory nerves for the nipple and areolar are deep in the breast, and therefore should not be affected by a simple breast lift. The fact that you’re having an implant removal may slightly affect this, but only up to a very small degree.

There is no surgery that is completely without risk, but the risk of permanently losing all nipple sensation or the ability for the nipples to react to temperature or tactile stimulation is uncommon. Some patients do experience temporary numbness immediately after surgery due to swelling and stretched nerves, but most regain this sensation within the first few months and it's rare to not regain it by a year.

Your question is excellent and one that many women have but often don’t get fully answered in detail.
Here’s a thorough, research-based answer to help you feel more informed and empowered:
Nipple Sensation Loss After Breast Lift (Mastopexy) – How Common Is It?
Types of Sensation Affected
When people talk about "losing nipple sensation," this can mean:
1. Tactile Sensation: The ability to feel touch.
2. Temperature Sensation: The ability to sense cold/warm stimuli (what you're describing as nipple erection or reaction to cold).
3. Erogenous Sensation: Sexual sensitivity.
These sensations are carried by small nerve branches (primarily the fourth intercostal nerve) that can be affected during surgery.
How Common is Sensation Loss?
Studies on breast lifts (mastopexy) show the following general trends:
• Temporary decreased sensation is very common right after surgery
• Permanent total sensation loss is relatively uncommon
• Temporary Numbness: ~60-80% of women experience reduced sensation immediately after surgery
• Partial Sensation Recovery: Most regain some or most sensation within 6-12 months
• Permanent Total Numbness: Only 5-15% of women may experience permanent, complete loss of nipple sensation
• Complete Recovery: Some studies suggest up to 80-90% of women regain significant sensation over time, but possibly not exactly as it was pre-surgery.
The wide range you’ve seen is likely due to:
• Differences in surgical technique
• Whether the patient had additional procedures (like implants, reductions, or removals)
• Individual healing variability
What About Nipple Erection / Temperature Response?
The ability for nipples to "erect" in response to cold or stimulation is an involuntary, nerve-mediated reflex.
Loss of this response is less commonly studied but generally correlates with loss of nerve function.
• If you lose all sensation (both touch and temperature), the nipple’s ability to "erect" may also be lost.
• However, most patients who retain some sensation usually retain this response.
• Complete flatness forever is rare, but it can happen
Risk Factors That Can Increase Numbness
• Large amounts of skin removal (major lifts)
• Nipple repositioning (especially if the nipple is fully detached, which is rare in most modern techniques)
• Multiple breast surgeries (you’re having implant removal, which may slightly increase risk but not dramatically)
• Smoking, poor circulation, or other healing issues
Overall, having conversations with your surgeon will help you understand how their techniques and your body will determine your recovery.