The authors performed a prospective study quantifying nipple-areola complex sensibility by computer-assisted neurosensory testing in breast hypertrophy before and after superolateral breast reduction.
A superolateral pedicle breast reduction was performed on 30 macromastia patients. The mean age of the patients was 46 years. The cup sizes of the patients were as follows: D, 14 patients; E, 12 patients; and EE, four patients. Ptosis was 3 degrees in 12 and 4 degrees in 18; nipple elevation ranged from 4 to 18 cm; glandular resection ranged from 379 to 1850 g. Static and moving one- and two-point discrimination was tested preoperatively and 6 months postoperatively at the nipple-areola complex, evaluating the impact of breast hypertrophy (D versus E and EE cups), nipple elevation (<9 cm versus ≥9 cm), and glandular resection (<900 g versus ≥900 g).
Statistical analyses revealed preoperatively significant higher pressure thresholds in the nipple-areola complex of larger versus smaller hypertrophies and in the nipple of longer nipple-areola complex transposition breasts for static and moving one-point discrimination. Postoperatively, worsening of sensibility was more significant in the nipple-areola complex of smaller versus larger hypertrophies and of shorter versus longer nipple-areola complex transposition breasts for moving one-point discrimination.
This study confirms that macromastia patients present a reduced breast sensibility, which is not necessarily worsened by reduction mammaplasty. After reduction mammaplasty with the superolateral pedicle technique, nipple-areola complex sensibility might be slightly reduced, which is less detectable in large-breast hypertrophy because of lower preoperative levels of sensibility and less of a postoperative decrease.
From the Plastic Surgery Unit, Sant’Andrea Hospital, Second School of Medicine, and Department of Experimental Medicine and Pathology, First School of Medicine, University of Rome “La Sapienza.”
Received for publication July 21, 2005; accepted October 24, 2005.
Presented at the 15th European Association of Plastic Surgeons Annual Meeting, in Genoa, Italy, May 27 through 29, 2004.
Fabio Santanelli, M.D., Ph.D., Unità Operativa di Chirurgia Plastica, Azienda Ospedaliera Sant’Andrea, Via di Grottarossa 1035-1039, 00171 Roma, Italia, firstname.lastname@example.org