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Breast Sensitivity Before and After the L Short-Scar Mammaplasty

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Abstract

Background

Breast sensitivity preservation is among the aims of modern breast surgery. Large-volume resection, extensive undermining, and resections at the breast base have been associated with breast sensitivity alterations. The L short-scar mammaplasty technique is designed to preserve breast sensitivity by resection of tissue in the middle and inferior portions of the breast, but specifically dissection and preservation of the breast lateral neurovascular pedicle. Using this technique, a prospective study was designed for measurement of breast sensitivity quantitatively and subjectively to determine whether different resection volumes of the breast correlate with alteration of sensitivity postoperatively.

Methods

This study compared the sensitivity of 125 breasts of 64 consecutive patients who underwent mastopexy or breast reduction with the L short-scar mammaplasty technique. Nine points were tested with Semmes-Weinstein monofilaments: the nipple and cardinal points on the areola and skin. The tests were performed by the same examiner 1 day before surgery and then 6 and 12 months after surgery. The breasts were divided into three groups according to the resected volume as follows: group A (≤200 g), group B (201–400 g), and group C (>400 g). The patients also were asked to complete written surveys 12 months postoperatively, and the response rate was 100%.

Results

Before surgery, larger breasts were observed to have less sensitivity in the areola (groups B and C, P < 0.001) and skin (group C, P < 0.001). After 12 months, no correlation was found between larger resected volumes and less breast sensitivity. The sensitivity of the nipple–areola complex in all the groups reached levels equal to the preoperative measurement within 12 months after surgery. After 6 and 12 months, significant improvement in skin breast sensitivity with resections greater than 200 g (group B, P = 0.002; group C, P < 0.001) was observed. After 12 months, 66.4% of the patients and 94.4% of the group C patients (average resection, 499 g) reported equal or better nipple–areolar sensitivity compared with preoperative sensibility. No patient reported areas of areola or nipple insensitivity.

Conclusion

After the L short-scar mammaplasty, breast sensitivity to pressure in most cases returns to preoperative levels or improves primarily in those with larger breasts. The data of this prospective study contradict the misconception that mammaplasty techniques with resections at the breast base leave the patient with reduced breast sensitivity because the fundamental neural pathways, such as the lateral neurovascular pedicle, are preserved.

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References

  1. Courtiss EH, Goldwyn RM (1976) Breast sensation before and after plastic surgery. Plast Reconst Surg 58:1–12

    Article  PubMed  CAS  Google Scholar 

  2. Gonzalez F, Brown FE, Gold ME, Walton RL, Shafer B (1993) Preoperative and postoperative nipple–areola sensibility in patients undergoing reduction mammaplasty. Plast Reconst Surg 92:809–814

    Article  PubMed  CAS  Google Scholar 

  3. Greuse M, Hamdi M, De Mey A (2001) Breast sensitivity after vertical mammaplasty. Plast Reconst Surg 107:970–976

    Article  PubMed  CAS  Google Scholar 

  4. Pitanguy I, Vaena M, Radwanski HN, Nunes D, Vargas AF (2007) Relative implant volume and sensibility alterations after breast augmentation. Aesthetic Plast Surg 31:238–243

    Article  PubMed  Google Scholar 

  5. Temple CLF, Hurst LN (1999) Reduction mammaplasty improves breast sensibility. Plast Reconst Surg 104:72–76

    Article  PubMed  CAS  Google Scholar 

  6. Schlenz I, Rigel S, Schemper M, Kuzbari R (2005) Alteration of nipple and areola sensitivity by reduction mammaplasty: a prospective comparison of five techniques. Plast Reconst Surg 115:743–751

    Article  PubMed  CAS  Google Scholar 

  7. Hamdi M, Greuse M, De Mey A, Webster MHC (2001) A prospective quantitative comparison of breast sensation after superior and inferior pedicle mammaplasty. Br J Plast Surg 54:39–42

    Article  PubMed  CAS  Google Scholar 

  8. Chiari A Jr (1992) The L short-scar mammaplasty: a new approach. Plast Reconst Surg 90:233–246

    Google Scholar 

  9. Würinger E, Mader N, Posch E, Holle J (1998) Nerve and vessel supplying ligamentous suspension of the mammary gland. Plast Reconst Surg 101:1486–1493

    Article  PubMed  Google Scholar 

  10. Regnault P (1976) Breast ptosis definition and treatment. Clin Plast Surg 3:193–203

    PubMed  CAS  Google Scholar 

  11. Bell-Krotoski J, Tomancik E (1987) The repeatability of testing with Semmes–Weinstein monofilaments. J Hand Surg 12A:155–161

    Google Scholar 

  12. Lehman LF, Orsini MB, Nicholl AR (1993) The development and adaptation of the Semmes–Weinstein monofilaments in Brazil. J Hand Ther 6:290–297

    PubMed  CAS  Google Scholar 

  13. Weinstein S (1993) Fifty years of somatosensory research: from the Semmes–Weinstein monofilaments to the Weinstein Enhanced Sensory Test. J Hand Ther 6:11–22

    PubMed  CAS  Google Scholar 

  14. Levin S, Pearsall G, Ruderman RJ (1978) von Frey’s method of measuring pressure sensibility in the hand: an engineering analysis of the Weinstein–Semmes pressure aesthesiometer. J Hand Surg 3:211–216

    CAS  Google Scholar 

  15. Ahmed OA, Kolhe PS (2000) Comparison of nipple and areolar sensation after breast reduction by free nipple graft and inferior pedicle techniques. Br J Plast Surg 53:126–129

    Article  PubMed  CAS  Google Scholar 

  16. Godwin Y, Valassiadou K, Lewis S, Denley H (2004) Investigation into the possible cause of subjective decreased sensory perception in the nipple–areola complex of women with macromastia. Plast Reconstr Surg 113:1598–1606

    Article  PubMed  Google Scholar 

  17. Harbo SO, Jorum E, Roald HE (2003) Reduction mammaplasty: a prospective study of symptom relief and alterations of skin sensibility. Plast Reconstr Surg 111:103–110

    Article  PubMed  Google Scholar 

  18. Hefter W, Elvenes OP, Lindholm PA (2003) Retrospective quantitative assessment of breast sensation after lateral pedicle mammaplasty. Br J Plast Surg 56:667–673

    Article  PubMed  CAS  Google Scholar 

  19. Mitrofanoff M, Dalassera M, Boukriss T, Baruch J (1997) Clinical study of breast sensitivity before and after reduction. Ann Chir Plast Esthet 42:314–323

    PubMed  CAS  Google Scholar 

  20. Slezak S, Dellon AL (1993) Quantitation of sensibility in gigantomastia and alteration following reduction mammaplasty. Plast Reconst Surg 91:1265–1269

    Article  PubMed  CAS  Google Scholar 

  21. Tairych G, Kuzbari R, Rigel S, Todoroff BP, Schneider B, Deutinger M (1998) Normal cutaneous sensibility of the breast. Plast Reconst Surg 102:701–704

    Article  PubMed  CAS  Google Scholar 

  22. Terzis JK, Vincent MP, Wilkins LM, Rutledge K, Deane LM (1987) Breast sensibility: a neurophysiological appraisal in the normal breast. Ann Plast Surg 19:318–322

    Article  PubMed  CAS  Google Scholar 

  23. Wechselberger G, Stob S, Schoeller T, Oehlbauer M, Piza-Katzer H (2001) An analysis of breast sensation following inferior pedicle mammaplasty and the effect of the volume of resected tissue. Aesthetic Plast Surg 25:443–446

    Article  PubMed  CAS  Google Scholar 

  24. Hamdi M, Blondeel PN, Van de Sijpe K, Van Landuyt K, Monstrey S (2003) Evaluation of nipple–areola complex sensitivity after the latero-central glandular pedicle technique in breast reduction. Br J Plast Surg 56:360–364

    Article  PubMed  Google Scholar 

  25. Franco T, Silva CC (1994) Sensibilidad areolomamilar. In: Coiffman F (ed) Cirugia Plastica: Reconstructiva y Estetica, 2nd edn. Masson-Salvat Medicina, Barcelona, pp 3428–3432

    Google Scholar 

  26. Mofid MM, Dellon AL, Elias JJ, Nahabedian MY (2002) Quantitation of breast sensibility following reduction mammaplasty: a comparison of inferior and medial pedicle techniques. Plast Reconstr Surg 109:2283–2288

    Article  PubMed  Google Scholar 

  27. Ferreira MC, Costa MP, Cunha MS, Sakae E, Fels KW (2003) Sensibility of the breast after reduction mammaplasty. Ann Plast Surg 51:1–5

    Article  PubMed  Google Scholar 

  28. Dellon AL (2003) Invited discussion: sensibility of the breast following reduction mammaplasty. Ann Plast Surg 51:6–9

    Article  PubMed  Google Scholar 

  29. Nahabedian MY, Mofid MM (2002) Viability and sensation of the nipple–areolar complex after reduction mammaplasty. Ann Plast Surg 49:24–31

    Article  PubMed  Google Scholar 

  30. McCulley SJ, Rousseau TE (1999) A modified Chiari L short-scar mammaplasty: the technique and results. Br J Plast Surg 52:112–117

    Article  PubMed  CAS  Google Scholar 

  31. Würinger E (1999) Refinement of the central pedicle breast reduction by application of the ligamentous suspension. Plast Reconst Surg 103:1400–1410

    Article  PubMed  Google Scholar 

  32. Cárdenas-Camarena L, Vergara R (2001) Reduction mammaplasty with superior-lateral dermoglandular pedicle: another alternative. Plast Reconst Surg 107:693–699

    Article  PubMed  Google Scholar 

  33. Blondeel PN, Hamdi M, Van de Sijpe KA, Van Landuyt KHI, Thiessen FEF, Monstrey SJM (2003) The latero-central glandular pedicle technique for breast reduction. Br J Plast Surg 56:348–359

    Article  PubMed  Google Scholar 

  34. Nahabedian MY (2005) Invited discussion: alteration of nipple and areola sensitivity by reduction mammaplasty: a prospective comparison of five techniques. Plast Reconst Surg 115:752–754

    Article  CAS  Google Scholar 

  35. Hamdi M, Greuse M, Nemec E, Deprez C, De Mey A (2001) Breast sensation after superior pedicle versus inferior pedicle mammaplasty: anatomical and histological evaluation. Br J Plast Surg 54:43–46

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Rua Herculano de Freitas, 58, Sala 110, Belo Horizonte, Minas Gerais, 30430-120, Brazil

    Armando Chiari Jr.

  2. Department of Surgery, Medical School of the Federal University of Minas Gerais, Av. Alfredo Balena, 190, S. 205, Belo Horizonte, Minas Gerais, 30130-100, Brazil

    Armando Chiari Jr. & Tarcizo A. Nunes

  3. Division of Plastic Surgery, Hospital das Clínicas da UFMG, Belo Horizonte, Minas Gerais, Brazil

    Armando Chiari Jr.

  4. Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

    James C. Grotting

  5. University of Wisconsin, Madison, Madison, WI, USA

    James C. Grotting

  6. Division of Plastic Surgery, Hospital Lifecenter, Av. Contorno, 4747, S. 1711, Belo Horizonte, Minas Gerais, 30110-921, Brazil

    Fernando B. Cotta & Rafael C. B. Gomes

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  1. Armando Chiari Jr.
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  2. Tarcizo A. Nunes
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  3. James C. Grotting
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  4. Fernando B. Cotta
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  5. Rafael C. B. Gomes
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Correspondence to Armando Chiari Jr..

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Chiari, A., Nunes, T.A., Grotting, J.C. et al. Breast Sensitivity Before and After the L Short-Scar Mammaplasty. Aesth Plast Surg 36, 105–114 (2012). https://doi.org/10.1007/s00266-011-9756-2

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  • DOI: https://doi.org/10.1007/s00266-011-9756-2

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