Breast reduction surgery reduces the weight and size of breasts and can help alleviate symptoms such as back pain, neck pain and bra strap grooving. Because the reduction will lift the breast, the result is typically a smaller, more shapely breast that sits higher up on one’s chest. The musculoskeletal benefits of breast reduction are universal and are consistently seen in every patient.
But with this tremendous benefit of breast reduction does come some trade-offs and potential concerns. The one obvious trade-off are the scars. But a frequent question is also about will I still have feeling in my nipples?
The first way to address that question is to discuss a common but inaccurate perception of breast reduction surgery. In general, the nipples are not removed from the breast mound. The size of the areola is often reduced, but the nipple and much of the surrounding areola never leaves its attachments to the underlying breast tissue. There is no need to remove the nipple except in those cases where the breast is very large and the woman wants a really small breast afterwards. The nipple stays on the breast tissue and is moved up along with the breast mound and its blood supply. This not only keeps the nipple alive but gives you the best chance of preserving your sensation and erection capability of the nipple.
The subject of nipple sensation after breast reduction (or breast augmentation) has been studied numerous times in the plastic surgery literature. While one must accept the risk that all sensation may be lost, studies show that the majority of women keep most if not all of their sensation afterwards. While some nerves that supply feeling do get cut during a typical reduction procedure, the feeling to the nipple and areola comes from many different nerve branches from various directions.
Some women actually have improved nipple sensation after a reduction, theoretically due to reducing the stretch on the nerves that supply the feeling input to the nipple. In my Indianapolis plastic surgery experience, I find that many women will go through a phase of extra or too much sensation for weeks after surgery known as hyperesthesia. The nipple may be very uncomfortable to touch or even brush against for awhile. One may have to wear pads over them for protection. This hyperesthesia eventually fades and one returns to a more normal comfortable sensation.
Preservation of nipple sensation is undoubtably also dependent on the amount of tissue removed. The less tissue removed, the less one has of having a numb nipple afterwards. However, the amount of breast tissue removed should be guided by the main objective of an uplifted and smaller breast.
In general, most women have no change from the procedure and their nipple sensation is kept intact. But the risk is always present and some patients may sacrifice some feeling for better shaped and less problematic breasts.
Dr. Barry Eppley
Indianapolis, Indiana