American Association of Plastic Surgeons

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Evaluation Of Permanent Nipple-areola Complex Sensitivity Loss Following Reduction Mammoplasty
Stephanie Francalancia, MS, Mary Lou, BS, Damon McIntire, MD, Nikhil Sobti, MD, Navya Baranwal, BA, Elijah Persad-Paisley, BA, Jesse Menville, BA, Brooke Barrow, MD, Josue Marquez, BS, Rachel Sullivan, MD, Paul Liu, MD, Karl Breuing, MD;
Brown University Warren Alpert Medical School, Providence, RI, USA

PURPOSE: Predictors for permanent nipple-areola complex (NAC) insensitivity after reduction mammoplasty are sparsely defined. We analyze factors associated with NAC insensitivity over a long-term follow-up.
METHODS: A retrospective analysis was conducted on 1596 reduction mammoplasties by the same three surgeons from March 2015-February 2023. Data on patient demographics, intraoperative factors, and postoperative complications were collected from patient records and summarized with descriptive statistics. Analysis was conducted by breast, separated into breasts with NAC insensitivity and those without. Studentís t-test for continuous variables and Fisherís exact test for categorical variables were used to evaluate differences between the two groups.
RESULTS: Of 1596 breasts, 9.59% had NAC insensitivity and 90.4% didnít. Of those with NAC insensitivity, 48.3% had permanent loss. 51.6% regained sensitivity, taking an average of 112 days (median 47, range 6-798) to regain sensation (Figure 1). NAC-insensitive breasts had longer sternal notch-NAC (p<0.001) and NAC-IMF (p=0.001) measurements, greater weight removed (p<0.001), and associated fat necrosis co-complication (p=0.018). Greater weight removed (p=0.041) and longer sternal notch-NAC measurement (p=0.023) were associated with permanent insensitivity. The superomedial pedicle (p=0.001) was significantly associated with any NAC insensitivity. However, there was not a significant difference in pedicle choice for permanent insensitivity.
CONCLUSION: Initial NAC insensitivity after reduction mammoplasty is associated with pedicle choice. However, insensitivity permanence is associated with longer breast measurements and greater weight removed.

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