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Nipple Sensation after breast augmentation

I saw a new patient just yesterday who is going to have a breast augmentation and she had a good question. Her nipples are overly sensitive and she was hoping that after her breast implants were placed her nipples might be less sensitive. She asked if this was likely.

The answer is that it is possible but not likely. With any breast surgery, whether we are doing a lift, a reduction, or an implant, the nerve that give the nipple are its feeling is at risk. As a rule the ‘deeper’ into the breast we go the more this becomes a possibility because the nerve in question enters the breast from its under surface and then branches come up to the skin level. So, if we are just on the surface, as in a lift, yes some of the tiny nerve branches will be cut resulting in some temporary sensory loss but the dominant nerve supply is intact and full sensation should return within a few weeks. That’s why when we make a circular incision around the nipple it doesn’t mean you will be numb afterwards. With a breast reduction, as this is a bit more invasive than a lift, the chances for sensory changes are higher and thus more common. It’s simply a matter of the surgeon being deeper into the breast to remove the excess tissue. Now with implants the risk is highest as we are placing the implant right at the level of the nerve, which is called the 4th Intercostal nerve. This nerve enters the breast from the side and moves towards the midline (your breast bone). Now as your surgeon, I know where this nerve lives and so when I get into that area I change how I develop the pocket for the implant in an effort to preserve full sensation. That being said, if you look at the implant manufacturers data, the rate of sensory disturbance after an augmentation is about 8% and when this happens it tends to be an all or none deal. So, my answer to the patient referenced above is that “No, your nipple sensation probably wont change and if it does lessen I have no way to control how much or how little.

Lee E. Corbett, MD

Medical Director, Corbett Cosmetic Aesthetic Surgery and MediSpa

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