Abstract
Background
Recent studies have provided diverging results regarding the factors that may affect sensibility after primary breast augmentation. Implant volume is believed to be an important factor, but the relation of implant size to breast volume has not been adequately addressed. In addition, the literature shows that a conflict exists when the periareolar and inframammary approaches are compared. This study aimed to refine the volumetric analysis comparing the implant and final breast size as well as the intrinsic association of these two factors with postoperative sensory alteration of the breast.
Methods
A prospective study investigated patients who underwent aesthetic breast augmentation between June 2004 and October 2005 (i.e., a 16-month period) at the Ivo Pitanguy Institute. The sensibility in nine regions of the breast was tested before and after surgery using Semmes-Weinstein monofilaments. Breast sizers were used to compare the pre- and postoperative breast volumes. Statistical analysis of the data took into consideration the relative volume of the implant, the surgical approach, the presence of minor complications, the breast-feeding history, and the subjective evaluation of sensory changes in the patients.
Results
A total of 37 patients who underwent breast augmentation were examined preoperatively. The relative volume of the implant was found to be associated with sensibility alterations. No difference was found between the periareolar and inframammary incision approaches. Other factors such as previous breast-feeding, minor complications, and subjective alterations were not associated with sensory alterations.
Conclusions
The study findings suggest that larger implants and smaller breasts show an increased association with postoperative sensory alterations of the breast. Plastic surgeons and their patients should be aware of this possibility. Implant volume should be considered together with breast size to avoid sensory complications, and this is summarized in the concept of relative volume.
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References
Information provided in the official ASPS site, this information from the American Society of Plastic Surgeons is currently available at the same electronic address online. Retrieved May 12, 2006 at http://www.plasticsurgery.org/public_education/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=17890. American Society of Plastic Surgery
Fiala TGS, Lee WPA, May JW: Augmentation mammaplasty: Results of a patient survey. Ann Plast Surg 30:503, 1993
Hetter GP: Satisfactions and dissatisfactions of patients with augmentation mammaplasty. Plast Reconstr Surg 64:151, 1979
Courtiss EH, Goldwyn RM: Breast sensation before and after plastic surgery. Plast Reconstr Surg 58:1, 1976
Schlenz I, Rigel S, Schemper ME, Kuzbari R: Alteration of nipple and areola sensitivity by reduction mammaplasty: A prospective comparison of five techniques. Plast Reconstr Surg 115:743, 2005
Mofid M, Dellon L, Elias J, Nahabedian M: Quantification of breast sensibility following reduction mammaplasty: A comparison of inferior and medial pedicle techniques. Plast Reconstr Surg 109:2283, 2002
Terzis JK, Vincent MP, Wilkins LM, Rutledge K, Deane LM: Breast sensibility: A neurophysiological appraisal in the normal breast. Ann Plast Surg 19:318, 1987
Okwueze MI, Spear ME, Zwyghuizen AM, Braun SA, Ajmal N, Nanney LB, Hagan KF, Wolfort SF, Shack RB: Effect of augmentation mammaplasty on breast sensation. Plast Reconstr Surg 117:73, 2006
Mofid M, MD, Klatsky S, MD, Singh N, Nahabedian M, MD: Nipple–areola complex sensitivity after primary breast augmentation: A comparison of periareolar and inframammary incision approaches. Plast Reconstr Surg117:1694, 2006
Nahabedian MY: Effect of augmentation mammaplasty on breast sensation: Discussion. Plast Reconstr Surg 117:84, 2006
Tairych GV, Kuzbari R, Rigel S, Todoroff BP, Schneider B, Deutinger M: Normal cutaneous sensibility of the breast. Plast Reconstr Surg 102:701, 1998
Gonzalez F, Brown F, Gold M, Walton R, Shafer B: Preoperative and postoperative nipple–areola sensibility in patients undergoing reduction mammaplasty. Plast Reconstr Surg 92:809, 1993
Benediktsson KP, Perbeck L, Geigant E, Solders G: Touch sensibility in the breast after subcutaneous and immediate reconstruction with a prosthesis. Br J Plast Surg 50:443, 1997
Schlenz I, Kuzbari R, Gruber H, Holle J: The sensitivity of the nipple–areola complex: An anatomic study. Plast Reconstr Surg 105:905, 2000
Farina MA, Newby BG, Alani HM: Innervation of the nipple–areola complex. Plast Reconstr Surg 66:497, 1980
Jaspars J, Posma A, Van Immerseel A, Gittenberger-de-Groot A: The cutaneous innervation of the female breast and nipple–areola complex: Implications for surgery. Br J Plast Surg 50:249, 1997
França AL, Scevola MC, Fachin SD, França PF, França NC: Mamasize: A new auxiliary instrument in the planning of enlargement mammaplasty (Mamasize: um novo instrumento auxiliar no planejamento das mamoplastias). Rev Soc Bras Cir Plas 20:204, 2005
Young VL, Nemecek JR, Nemecek DA: The efficacy of breast augmentation: Breast size increase, patient satisfaction, and psychological effects. Plast Reconstr Surg 94:958, 1994
Spear SL, Matsuba H, Little J III: The medial periareolar approach to submuscular augmentation mammaplasty under local anesthesia. Plast Reconstr Surg 84:599, 1989
Pitanguy I: Transareolar incision for augmentation mammaplasty. Aesth Plast Surg 2:363, 1978
Tebbets JB: Transaxillary subpectoral augmentation mammaplasty: Long-term follow-up and refinements. Plast Reconstr Surg 74:497, 1980
Banbury J, Yetman R, Lucas A, et al. Prospective analysis of the outcome of subpectoral breast augmentation: Sensory changes, muscle function, and body image. Plast Reconstr Surg 113:701, 2004
Sarhadi N, Dunn J, Lee F, Soutar D: An anatomical study of the nerve supply of the breast, including the nipple and areola. Br J Plast Surg 49:156, 1996
Acknowledgment
The authors express their gratitude to Mr. Clayton Amaral Domingues, PhD., for his expertise in the statistical analysis.
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Pitanguy, I., Vaena, M., Radwanski, H.N. et al. Relative Implant Volume and Sensibility Alterations After Breast Augmentation. Aesth Plast Surg 31, 238–243 (2007). https://doi.org/10.1007/s00266-006-0173-x
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DOI: https://doi.org/10.1007/s00266-006-0173-x