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From DIEP Flap and TUG Flap procedures to lesser-known SHAEP and Stacked Flaps, we offer a range of natural tissue reconstruction and breast sensation restoration options. Whether you're interested in direct-to-implant or expander implant reconstruction, we are experienced in both prepectoral and subpectoral approaches. We perform a wide range of procedures, like conversion to prepectoral implants, flap revision, fat grafting, and surgery on the opposite breast, to improve your breast reconstruction. We offer surgical and non-surgical options, like 3-D tattoo, that allow our surgeons to create a natural appearing nipple as the final touch for your breast reconstruction. We help our patients understand the types of mastectomies available and how genetic information, like BRCA gene mutations, can factor into your decisions. We pioneered a unique and reliable abdominal wall reconstruction procedure to repair TRAM flap related hernias and contour deformities. We offer procedures to help prevent as well as ease lymphedema, a condition where limbs swell after lymph node removal. Radiation can be an important part of your breast cancer treatment. Learn how to coordinate it with your reconstructive timing and approach. For men facing mastectomy, we offer a variety of procedures including natural tissue flaps, fat grafting, and nipple reconstruction. Our team can help you navigate surgical options from facelift and browlift to necklift and eyelid rejuvenation. Non-surgical facial rejuvenation options include Botox, fillers, laser peels, and chemical peels. In addition to nose-reshaping, our surgeons perform procedures that can alleviate breathing difficulties associated with deviated septum and internal nasal blockages. We’re experts in cosmetic breast procedures, including augmentation with fat grafting, implant augmentation, reduction, and lift. Liposuction, abdominoplasty, or tummy tuck, and butt augmentation can all reshape the body to improve your appearance. We offer brachioplasty, or arm lift, and thigh lift to transform your extremities. Enjoy body sculpting and facial rejuvenation treatments like CoolSculpting, IPL, Microneedle Skin Tightening, and more administered by our Aesthetician. Oncoplastic procedures like oncoplastic closure, reduction and lift, and local tissue flaps for volume loss preserve breast shape after a lumpectomy. A systematic approach to post mastectomy pain. Specialized tattooing and micro-needling can help create or refine nipple reconstruction, manage scars, and more. Tattooing can create permanent makeup, improve the appearance of hair density, and more.
Home > Breast Reconstruction > Breast Implant Reconstruction > Restoring Sensation in Implant Reconstruction

Summary

When patients undergo a nipple-and-skin-sparing mastectomy, the breast skin tends to be numb after surgery. Sensation may return over time, however, the extent of that sensation recovery is hard to predict. Nerve grafting at the time of mastectomy can greatly increase the chances that the patient will regain sensation in the breast. Our surgeons can use a nerve graft from a sensory nerve that comes out of the chest wall. That graft is connected to another sensory nerve in the region of the nipple areola.

Types of procedures

To restore sensation, nerves can be reconnected in several ways:

  • Nerves can be stitched directly to each other
  • When there is a space between two nerves, a nerve allograft and nerve connectors can be used to line up and attach the nerves.

Procedure details

  • The nipple-and-skin-sparing mastectomy is performed by a breast surgeon
  • While the mastectomy is underway, a plastic surgeon begins the process of preparing nerve grafts
  • Nerve grafts are stitched to a sensory nerve on the chest wall
  • A breast implant is placed to complete the breast reconstruction
  • Using microsurgery techniques, the nerve graft from the chest wall is connected to a target, sensory nerve in the region of the nipple areola
  • In the months after surgery, the nerves will re-sprout, potentially improving sensation

Risks & Benefits

Connecting nerves in order to improve sensation can add to the length and technical difficulty of surgery. Also, not all patients will have restored sensation.

Since many patients will get at least some sensation back over time, even without the additional step of reconnecting nerves, most plastic surgeons do not feel the need to add this procedure. With high quality mastectomies, even more sensation may remain on the reconstructed breast. What we know is that satisfaction rates are higher if sensation is restored, and the risk of post-mastectomy pain may be less.

Frequently Asked Questions

Is reconnecting nerves an option if my breasts were reconstructed with natural tissue?

Yes, natural tissue reconstruction patients can undergo a procedure that connects nerves in the flap to nerves in the chest.

Since nerves are cut as part of this procedure, will I have more pain?

When nerves at the mastectomy site are connected to nerves on the flap, there is little risk of added pain.

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