Q: Dr. Eppley, I’ve heard that some breast augmentations have resulted in a decrease in feeling or sensation in the breast, especially the nipple area. Is it true that a breast lift can be done in a way that will not result in the loss of feeling?
A: While the potential for loss of some or all of nipple sensation can occur with any breast operation, that risk differs based on what type of breast surgery is being done. Breast augmentations and breast lifts are both procedures done to enhance the look of the breasts. But they are completely different operations and should not be confused in their potential effect on nipple sensation. Breast augmentation involves the placing of any implant in a pocket either on top of or under the chest muscle. It is in essence an ‘internal’ breast procedure whose pocket dissection may place at risk nerves that are making their way to the nipple from the chest wall through the breast tissues. Breast lifts are done by removing skin, lifting the breast tissue which contains the attached nipple upwards and tightening the remaining skin around the elevated breast mound. It is thus largely an ‘external’ breast procedure and does not usually involve dissection near the nerves that supply sensation to the nipple. These differences make the risk of decreased nipple sensation greater in breast augmentation than in breast lifts. Often implants and lifts are combined which pose the greatest risk to nipple sensation.
There are different types of breast lifts and some have virtually no risk of changing one’s nipple sensation. These are the first three types of breast lifts (superior crescent, periareolar and vertical) which do not involve dissection around the base of the breast mound.
Dr. Barry Eppley
Q: Hi I had a breast reduction and then a scar revision over 15 years ago. Then last year I had a breast augmentation. Since then both nipples and parts of the breast are numb and I have no nipple sensation. Only when the nipples are pinched can I feel anything. Was having a breast reduction previously the reason that I have no nipple sensation now?
A: While breast reduction does decrease the amount of breast tissue, I am not aware that it would make one at more risk for nipple sensation later after a breast augmentation. I do not believe that the two are related other than both breast procedures were done on you.
The more likely explanation is that you have suffered nipple sensation loss exclusively because of the breast augmentation procedure. This is one of the know risks of the procedure although my experience is that it is very uncommon. While the nipple receives innervation from different nerve inputs, a major nerve supply comes from the side of the chest. The location of this nerve does place it at risk for a stretch injury during pocket development for a breast implant during the procedure. This is why I always only do blunt finger dissection when making the pocket to the side and to make sure it does not go too far too the side as well.
If you still have persistent numbness after a year after surgery, it is likely the loss of nipple and skin sensation will be permanent.
Dr. Barry Eppley