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Targeted Nipple Areolar Complex Reinnervation In Implant Based And Autoogous Breast Reconstruction Following Mastectomy
Kassandra Carrtion, BA1, Nitya Devisetti, BS
2, Nataly Montano Vargas, ScM
1, Athena Le, BS
1, Allison Hu, MD
1, Dung Nguyen, MD, PharmD
1.
1Stanford University, Palo Alto, CA, USA, 2Rutgers, Newark, NJ, USA.
PURPOSE:Targeted reinnervation of the nipple areola complex(NAC) in breast reconstruction after nipple sparing mastectomy has been shown to enhance recovery of sensation. We report sensation restoration in gender affirming mastectomy, implant-based, and autologous breast reconstruction.
METHODS:A retrospective chart review was conducted on 122 patients who underwent FTM gender-affirming mastectomy, and breast reconstruction with and without targeted NAC innervation. BREASTQ was sent to patients post-operatively. Semmes-Weinstein monofilament testing was used to measure sensation.
RESULTS:Of 61 patients who had breast reconstruction, 18 had implants, 23 had flaps, and 7 had hybrid reconstruction. Average age at surgery was 46.1±10.8 years for the breast reconstruction group, and 22±9.5 years for the TG group. The average number of grafted nerves was 2.3±1.0 for flaps, 2.5±1.2 for implants, and 2.7±1.9 for hybrids. Semmes-Weinstein monofilament testing showed statistically significant recovery of sensation in all segments of patients who underwent NAC reinnervation compared to those who were not reinnervated (Table 1). Patients who underwent gender affirming mastectomy had significantly better sensation recovery than breast reconstruction patients. The flap group had better sensation compared to implant and hybrid groups. 91.7% patients said they would choose the same operation again.
CONCLUSION:This is the largest study analyzing sensory outcomes following targeted nipple areola complex neurotization in breast reconstruction and FTM gender-affirming mastectomy. Our results show sensory restoration is superior in patients with targeted NAC reinnervation.
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