Loss Of Nipple Sensation After Breast Implants

Loss of sensation is not very common. It can happen when placing implants.

On the other hand, short term sensory change is quite common. This may be due to swelling and usually gets better within a few weeks after surgery.

One theory: The larger the implant, the more likely it could happen.

This may be due to stretching of the tissues ans subsequently the sensory nerve fibers that go to the nipple.

No sensation in breast photos

There is no strong evidence suggesting any one incision is more likely to cause it. (Steven Wallach, MD, Manhattan Plastic Surgeon)

There are a lot of misconceptions about this, but it is rarely a long-term problem. Many still tell their patients that the areolar margin incision has a higher incidence of sensory loss to the nipple, but more recent studies have disproven that.

One study from Brazil found that larger implants have a higher risk of sensory loss, which makes sense because the dissection required to make a larger space for the implant may get closer to where the nerves are. The take-home message is that it should not be the basis for deciding on where the incision is made, but something to think about if you are considering a larger size. (Richard Baxter, MD, Seattle Plastic Surgeon)

It is not inevitable and in most cases patients will not loss sensation in their nipples. Most incisions are made away from the nipple, therefore avoiding any reason for loss of sensation. (Kimberly A. Henry, MD)

Sensation to the nipple is usually preserved with breast augmentation. The key word here is usually. Any surgery can cause loss of sensation. There has been a significant amount of research into nipple sensation. The cutaneous innervation of the female breast is derived medially from the anterior cutaneous branches of the Ist-VIth intercostal nerves and laterally from the lateral cutaneous branches of the IInd-VIIth intercostal nerves. The nipple-areola complex is consistently supplied by the anterior and lateral cutaneous branches of the IVth intercostal nerve, with additional innervation by cutaneous branches of the IIIrd and Vth intercostal nerves.

This means that the threats to nipple sensation include the following:

Where is the incision for the augmentation placed?
What nerves have been injured during pocket dissection?
Does the size of the implant stretch the nerve?

Sometimes injuries to the nerve (especially from the third reason) will resolve over time (typically 6 months to a year) but in rare cases sensation loss can be permanent. Be sure to discuss your concerns with a board certified plastic surgeon! (Steven H. Williams, MD, San Francisco Plastic Surgeon)

Breast implant surgery rarely results in a permanent loss of sensation. However, any surgery on the breast can possibly produce numbness and the only way to be assured that this will not happen is to not have the surgery. The other factors that increase the risk of sensory loss are the surgical technique and the size of the implant.

Large implants stretch the nerves more and are more prone to causing numbness. If a patient experiences some loss of sensation after surgery, taking B complex vitamins may be helpful. It is possible to recover some or all sensation over many months to a few years post-op.

A few patients experience “hypersensitivity” after surgery which is the opposite of numbness. In these patients, excess sensitivity is present and in my experience is always temporary and resolves with time and massage. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)

Although most girls ask questions and express concerns about breast/nipple sensation during a preoperative consultations, the truth is that rarely it is a problem after surgery.

Although loss of nipple sensation is certainly possible, it does not seem to be a common problem. What is even more interesting, loss of nipple sensation is not associated with particular incision site, as recent studies showed most loss occured during inframmary incisions. Therefore, nipple and axillary incisions are not only safe but might be better in preserving nipple sensation. (Gregory Turowski, MD, PhD, FACS, Chicago Plastic Surgeon)

Nipple Sensation After Breast Augmentation

Generally, there is minimal, partial, and usually temporary loss of nipple sensation following breast augmentation.

I perform most breast augmentation (both above and below the muscle) through the peri-areolar approach, unless a patient has an existing incision in the inframammary fold below the breast, or unless I am using the cohesive gel textured implants, which generally require an incision larger than the diameter of the areola. I find that my patients often report a heightened sensitivity of the nipples following breast augmentation, which I believe is due to the fact that the breast and nipple surface area is increased by the presence of the implant. Patients can lose sensitivity regardless of the incision approach, however, and I find that patients who have had multiple breast surgeries are more likely to experience loss of sensitivity of the nipple. (Athleo Louis Cambre, MD, Los Angeles Plastic Surgeon)

While there is a small chance that you can loose sensation in the nipple after breast implant, this is not something that happens often and I would not think that you should shy away from breast implants for this reason alone.

In my practice in Santa Barbara, I prefer the inframammary approach for breast implants, and I have not seen any nipple numbness in my patients. Make sure you discuss this concern with your plastic surgeon, and he or she can perform some particular maneuvers to try and make sure your risk is low.

I recommend the lower inframammary incision, as well as making sure that the lateral dissection, where the nerve to the nipple lies, is performed with blunt dissection rather than sharp cutting or cautery. (Adam David Lowenstein, MD, FACS, Santa Barbara Plastic Surgeon)

Bigger implants requiring larger pockets may contribute to more numbness. Implants placed by surgeons making thin skin flaps (a technical issue) can also result in more numbness.

Most patients see little change in their sensation unless they are going quite larger and/or are in inexperienced hands. (John P. Di Saia, MD, Orange Plastic Surgeon)

Loss of sensation in breast implants

There is always a risk of decreased sensation or loss of sensation to the breast or nipple areola after breast implants, though the risk is small but it is there. The only precaution you can take is to choose an experienced board certified plastic surgeon. If you are still worried, then do not do the surgery. (Samir Shureih, MD, Baltimore Plastic Surgeon)

Uncommon to lose sensation after breast implants

This is an uncommon complication. You may be referring to loss of sensation to the breast skin or to the nipple itself. It is not uncommon to have TEMPORARY decreased sensation to the breast skin immediately after the surgery, but this recovers. Regarding the nipples, this is an uncommon complication and is independent of the incision placement. If you have breast asymmetry, I would think the benefits of the surgery far outweigh the small chance of this happening to you. (Jeffrey Horowitz, MD, Bel Air Plastic Surgeon)

Loss of sensation after breast implants

All procedures do have the risk of loss of sensation. There are several different approaches used to place implants and each has its unique risk of sensory loss.

Most physicians choose the approach they were taught in training and tend to lead the patient towards what they are most comfortable with. We perform over 1000 breast augmentations per year and used every approach from, nipple, crease, axilla, TUBA or TABA.

The risk of sensory changes tends to be higher with IMF and NAC then through the tuba or trans axillary approaches. out of the over 700 TUBA procedures we have never had loss of sensation. I believe you should only choose someone who has experience with all of the approaches so they can give you and very open and honest answer to the various approaches. (William J. Hedden, MD, Birmingham Plastic Surgeon)

There is a real risk of nerve loss after breast implants, but this can be ameliorated by careful dissection, inframammary incision placement, and minimal injury to the pectoralis fascia.

Discuss these risks with your plastic surgery and ask for a real estimate of risks before you proceed. (Raffy Karamanoukian, MD, FACS, Los Angeles Plastic Surgeon)