Sensitivity of the Nipple-Areola Complex in Reduction Mammaplasty Following Periareolar Dermis Section

Abstract

Background Preservation of the periareolar dermis, after de-epithelization in reduction mammaplasty, may result in reduced nipple-areola complex (NAC) mobility. Consequently, distortion in shape and difficulty correcting the areola position can occur. Objectives The aim of this study was to evaluate NAC viability and sensitivity resulting from periareolar dermis section after de-epithelization in patients who underwent reduction mammaplasty surgery. Methods This study was a randomized, controlled double-blind clinical trial. A total of 41 patients (82 breasts) were randomly allocated into 2 groups and underwent reduction mammaplasty—involving the superior pedicle—with a final inverted T-shaped scar. A sectioning of the periareolar dermis was performed on the breasts in the experimental group. Semmes-Weinstein monofilaments were used to evaluate NAC sensitivity at the preoperative evaluation, and 3, 6, and 52 weeks after surgery. Results No cases of partial or total NAC necrosis were noted in either group. The comparison between the groups did not show significant differences regarding NAC sensitivity. However, a statistically significant difference was noted when sensitivity levels at the preoperative evaluation and 3 weeks after surgery were compared in the experimental group. A significant difference was noted when the scores of the sensitivity 3 weeks after surgery were compared between the control and the experiment groups. Nevertheless, after 1 year, no statistical differences were observed in the experimental group or between both groups. Conclusions The sectioning of the periareolar dermis does not affect the viability or the pressure sensitivity of the NAC. Level of Evidence: 4

Impact of Patient and Operative Factors on Nipple-Areola Complex Sensation after Bilateral Reduction Mammaplasty

“…Some have found lower sensory thresholds postoperatively via monofilament testing that subsequently improved over 1–2 years. 3 , 22 , 23 In contrast, Longo et al noted that NAC sensation continued to decrease between 6 months and 2 years postoperatively via PSSD in 30 women who underwent superolateral reductions. 24 We counsel all of our patients preoperatively that NAC sensation frequently decreases after surgery, but increases in a small number of patients.…”

Surgery for gigantomastia at the AKANDA Army Training Hospital: Analysis of 4 cases and literature review

“…Its pathogenesis is poorly understood, but it seems to be due to the reduced mobility of the PAM secondary to peri-areolar de-epidermisation. 48 The quality of healing after breast oncoplasty cannot be assessed before the 6th or even 12th month. 49 Similarly, scarring is a histological and physiological phenomenon that is often uncontrollable or even random.…”