Background: Studies of alterations in breast sensibility after augmentation mammaplasty have produced conflicting results. Such discrepancies may be attributed to unsophisticated measuring devices used in earlier studies leading to less accurate measurements and to the comparison of results to different surgical techniques. The primary purpose of our study was to conduct a prospective clinical trial to quantify specific sensory outcomes before and after submuscular breast augmentation.
Methods: Preoperative and postoperative questionnaires were used to assess patients' subjective observations on breast sensation. Quantitative data were collected using a very accurate device, the Pressure-Specified Sensory Device, to assess objective breast sensation. Thirty-three micromastia patients underwent quantitative measurements preoperatively (baseline), at 2 to 4 weeks and 6 months postoperatively to assess breast sensitivity.
Results: The quantitative data showed similar patterns of sensory change between both the periareolar and the inframammary surgical approach over time. The inferior region was the only region that showed a diminished sensitivity threshold of 9.5 ± 2.9 gm/mm2 for the inframammary incision, a significantly poorer average than the periareolar incision of 1.7 ± 0.6 gm/mm2 with p = 0.008 at 6 months. Older patients had significantly higher thresholds of sensitivity compared with younger patients (p < 0.02).
Conclusions: Our study suggests that the periareolar incision may produce less sensory loss in the lower pole of the breast when compared with the inframammary incision. The outcome of this study provides both the surgeon and the patient with concrete information regarding mammary sensation after augmentation mammaplasty and leads to a better informed-consent process.
From the Department of Plastic Surgery, Vanderbilt University Medical Center.
Received for publication November 4, 2004; revised January 24, 2005.
R. Bruce Shack, M.D., Department of Plastic Surgery, Vanderbilt University Medical Center, 230 Medical Center South, 2100 Pierce Avenue, Nashville, Tenn. 37232, firstname.lastname@example.org