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Alteration of Nipple and Areola Sensitivity by Reduction Mammaplasty: A Prospective Comparison of Five Techniques

Schlenz, Ingrid M.D.; Rigel, Sandra M.D.; Schemper, Michael M.D., Ph.D.; Kuzbari, Rafic M.D., Ph.D.

Plastic and Reconstructive Surgery: March 2005 - Volume 115 - Issue 3 - p 743-751
doi: 10.1097/01.PRS.0000152435.03538.43
Original Articles: Breast

The preservation of the sensitivity of the nipple-areola complex after reduction mammaplasty is an important goal. The authors performed this prospective study to accurately assess whether sensitivity changes are influenced by the weight of resection or the surgical technique. Eighty patients who underwent bilateral breast reduction (Lassus, 10 patients; Lejour, 13 patients; McKissock, 18 patients; Würinger, 20 patients; and Georgiade, 19 patients) were tested for sensitivity changes of the nipple and cardinal points of the areola with Semmes-Weinstein monofilaments before surgery, at 3 weeks, and at 3, 6, and 12 months after surgery. Patient characteristics (age, body mass index, and preoperative sensitivity) were statistically similar in all groups. The mean resection weight was significantly smaller in the Lassus (540 g) and the Lejour groups (390 g) than in the Georgiade group (935 g). The sensitivity of the nipple and the inferior and lateral part of the areola was significantly lower after a superior pedicle technique (Lassus and Lejour) than after any other technique at 3 weeks and at 3, 6, and 12 months postoperatively. Insensate nipples and areolas were found only after breast reductions with the Lassus and the Lejour techniques (47.8 percent). Nipple sensitivity after breast reduction by the other techniques was unchanged (Würinger, McKissock, and Georgiade) or sometimes even improved (Georgiade) as early as 3 weeks postoperatively. Changes in nipple and areola sensitivity after reduction mammaplasty depend on the surgical technique rather than the weight of resection. Superior glandular pedicle techniques that require tissue resections at the base of the breast are associated with a higher risk of injury to the nerve branches innervating the nipple-areola complex.

Vienna, Austria

From the Department of Plastic and Reconstructive Surgery, Wilhelminenspital, and the Department for Biometry and Statistics, University of Vienna.

Received for publication February 2, 2004; revised April 9, 2004.

Presented at the 13th Annual Meeting of the European Association of Plastic Surgeons, in Vienna, Austria, May, 31, 2003, and the 41st Annual Meeting of the Austrian Society of Plastic, Reconstructive, and Aesthetic Surgery, in St. Pölten, Austria, October 16, 2003. Awarded the prize for best clinical paper.

Ingrid Schlenz, M.D., Department of Plastic and Reconstructive Surgery, Wilhelminenspital, Montleartstrasse 37, 1160 Vienna, Austria, ingrid.schlenz@wienkav.at

©2005American Society of Plastic Surgeons