4 Weeks Post Op Breast Implants Silicone Under Muscle Normal to Have Numb Nipple Still an Pain on Bottom Crease of Breast?

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.  You are still very early in the postoperative period and your description sounds typical.  The nipple pain is likely your nerves regnerating.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.

When implant is inserted behind the breast the cutaneous nerves are stretched and sometimes do not function for period of time after the augmentation. Over time they will recover and sensibility to the nipple will return. The longest period of nipple anesthesia I have seen is six months.

Hello and thanks for your question. Decreased or lost nipple sensation is a risk of breast implant surgery which can affect 1 to 4% of patients. Sensation can return within a few weeks, but I have been told by a few patients that it took 2 years for full sensation to return to normal. I recommend you seek guidance from your plastic surgeon about this concern. Best wishes, Dr. Aldo.

Dear PM, 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.Best Wishes,Pablo Prichard, MD

This can be very normal. It can take up to 4 to 6 months for your breasts to resume normal sensation and settle into place. It's very important that you check in with your plastic surgeon for a quick check to make sure that the pain you are having is normal. I suspect it is, but always better safe than sorry. It's very rare that sensation does not return, but there is always a chance that this can happen. I strongly recommend patience!

Best of luck,

Jennifer Harrington MD

I would say the the pain and odd sensations, and the differing firmness are very common at this stage. 

The numbness at four weeks I would not call normal, but it does happen. Most, but not all, regain the sensation, usually by 3 to six months. Follow with your surgeon, who is probably a much better resource for your questions than are surgeons who have never seen you.  All the best

You questions you ask are all normal occurrences at this stage of your recovery.  Sensation usually returns to normal over 3-6 weeks but can take 9 months or more.  Pain along the outside of the breast is normal as well.  This usually resolves with time.  Most patients report that by 6-12 weeks they don't even think about their implants anymore, they are just part of them.  Be patient.