Link to article: Neurotization of
the Nipple-Areola Complex during Implant-Based Reconstruction: Evaluation of
Early Sensation Recovery
by Djohan, Risal; Scomacao, Isis; Knackstedt, Rebecca;
Cakmakoglu, Cagri; Grobmyer, Stephen R.
Plastic and
Reconstructive Surgery: August 2020 -
Volume 146 - Issue 2 - p 250-254
Summary:
The concept of sensate autologous breast reconstruction is
not novel, and prior literature has focused mainly on sensate abdominally based
breast reconstruction. The goal of this article is to present the authors’
results with a novel technique performing sensate implant-based reconstruction.
A database was prospectively maintained for patients who underwent
implant-based sensate breast reconstruction. The anterior branch of the lateral
fourth intercostal is identified and preserved during the mastectomy by the
breast surgeon. A processed nerve allograft is used as an interpositional graft
connecting the donor nerve to the targeted nipple-areola complex. The sensory
recovery process was objectively monitored using a pressure-specified sensory
device. Thirteen patients underwent the proposed technique. Eight patients with
15 breasts were monitored for sensory recovery. For sensory measurement, the
nipple had a mean threshold of 67.33 ± 34.48 g/nm2. The upper inner (29 ± 26.75
g/nm2) and upper outer (46.82 ± 32.72 g/nm2) nipple-areola complex quadrants
demonstrated better scores during the moving test compared with the static
test. Mean time between the test and surgery was 4.18 ± 2.3 months, and mean
time between the second test and surgery was 10.59 ± 3.57 months. Threshold
improvements were documented after the second test for all nipple-areola
complex areas evaluated. This is the first study to report on early results
obtained after performing sensate implant-based breast reconstruction. More
studies are required to determine the long-term outcomes and impact on quality
of life and to assess whether patient or breast characteristics impact the
success of this procedure.
