Breast Reinnervation

Spiegel, Aldona J.; Menn, Zachary K.; Eldor, Liron; Kaufman, Yoav; Dellon, A. Lee

doi:10.1097/gox.0000000000000008

Cited by 90 publications

(74 citation statements)

References 16 publications

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“…Our respondents indicated that mainly their partner enjoyed their breasts during an intimate setting, however for this function erogenous sensation is not necessary. This might be clinically relevant, because technically we are able to perform a microsurgical nerve coaptation and restore breast sensation, light touch [ 6 ]. However, restoration of erogenous sensation is rather an exception [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although excellent cosmetic results can be achieved with autologous breast reconstruction, most reconstructed breasts fail to regain sensation [ 5 ]. Technically, surgeons are able to perform a sensible nerve coaptation [ 6 – 10 ]. Currently, multiple randomized studies are on their way to provide level A evidence on the effect of nerve coaptation therefore it is not yet standard treatment.…”

Section: Introductionmentioning

confidence: 99%

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What does a breast feel like? A qualitative study among healthy women

et al. 2018

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BackgroundRestoring the body as normal as possible increases quality of life. Aesthetically, almost perfect breast reconstructions can be created. However, these reconstructed breasts have almost no sensation. Our hypothesis is that if we succeed in restoring sensation, this will increase quality of life. So far, little is written about the phenomenon of breast sensation, which makes it difficult to evaluate whether the quality of life increases after restored sensation. Therefore, the primary goal of this study is to determine what the importance and meaning is of breast sensation among healthy women.MethodsA qualitative, descriptive phenomenological study was performed in an academic hospital between October 2016 and March 2017. A total of 10 semi-structured in-depth interviews were conducted in healthy women who did not undergo prior breast surgery. The sample size was based upon ‘saturation’. The interviews were tape-recorded, transcribed verbatim, coded and analysed according to phenomenology keeping in mind the research question ‘what is the importance and meaning of sensation of the breast?’ResultsSeven interrelated themes on how sensation of the breast is experienced were found: the absent breast (1), the present breast (2), the well-functioning breast (2a), the feminine breast (2b), the sensual breast (2c), the alien breast (2d), the safe breast (2d).ConclusionsThe seven interrelated themes can form the basis to develop a quantitative research tool to evaluate quality of life after innervated breast reconstruction and can be implemented in counselling before breast reconstructive surgery in the form of shared treatment decisions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What does a breast feel like? A qualitative study among healthy women

et al. 2018

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“…Female breast innervated by the lateral and anterior cutaneous branches of the intercostal nerves from the second to the sixth nerves which are scarified during breast mammaplasty [12]. Breast re-innervation is not done by most surgeons; they mainly depend on the regeneration of nerves from the adjacent residual post-mastectomy skin [13].…”

Section: Discussionmentioning

confidence: 99%

Dermatomal Somatosensory Evoked Potentials: An Indicator of Improvement of Breast Sensibility after Reduction Mammaplasty

Abu-Hegazy¹,

Gabr²,

Ismail³

et al. 2016

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Introduction: Many women think about reduction mammaplasty for different reasons. The effect of surgery on the beast sensibility is one of the greatest concerns after reconstructive reductive breast surgery through its affect on patient's social life and psychological health. The dermatomal somatosensory evoked potential (D-SEP) is a new method to quantitatively evaluate breast sensibility. Patients and Methods: Twenty-five women enrolled in this study presenting with breast enlargement, underwent mammary reduction by using the inferior pyramidal breast reduction technique using the same operative technique described by Robbins with some modifications. All D-SEP amplitudes and latencies were calculated preoperatively and then were reassessed six and twelve months post-surgery in each breast. Result: The results revealed that there is a significant difference in the D-SEP latency pre-and post-operatively. The statistically significant decrease in latency and the breast size demonstrated indicates that the sensibility improved after breast reduction surgery both at six and twelve months. There is also a significant increase in the D-SEP amplitude pre-and post-operatively. The negative and statistically significant increase in amplitude with the decrease in breast size demonstrated indicates that the sensibility improved after breast reduction surgery both at six and twelve months. Conclusion: This study concluded that breast sensibility will improve after breast reduction as indicated by significant reduction of D-SEP latencies and increase of its amplitudes. Our results confirm an inverse relationship between breast size and sensibility, with improvement in sensibility after breast reduction.

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“…The presence of sensation in the reconstructed breast has shown to improve patient satisfaction and quality of life [53]. The neurotization of abdominally based free tissue transfers have shown to have significantly increased sensory recovery [53,54]. Coaptation of the flap nerve is typically performed to the anterior branch of the third intercostal nerve (Figure 24).…”

Section: Adjunctive Procedures 91 Neurotizationmentioning

confidence: 99%

“…The benefits of using the anterior branch of the third intercostal nerve is minimal dissection needed and it is in the vicinity of the vascular anastomoses. A less commonly used donor nerve is the lateral cutaneous branch of the third or fourth intercostal nerve because it can be damaged with the mastectomy procedure and is far away from the flap pedicle [54]. If primary coaptation of the nerves is not possible, a nerve conduit or graft can be used to improve sensibility.…”

Section: Adjunctive Procedures 91 Neurotizationmentioning

confidence: 99%

Immediate Breast Reconstruction with Free Autologous Tissue Transfer

Zelones¹,

Inchauste²,

Nguyen³

2020

Breast Cancer and Breast Reconstruction

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Immediate breast reconstruction in the United States is increasing with the majority of patients undergoing implant-based reconstruction. The use of pedicled autologous tissues has also been used, but due to significant donor site morbidity, free autologous tissue transfer has largely replaced it. The gold standard currently for breast reconstruction is free autologous tissue transfer from the abdomen if no contraindications exist. However, not all hospitals have the expertise available to perform free autologous tissue transfers for breast reconstruction. Other donor sites available for free autologous tissue transfer include the thigh and gluteal areas. With advances in free tissue transfer techniques, the donor site morbidity and flap failure rates are minimal. The ultimate goal for any breast reconstruction patient is to achieve the appropriate size, shape, symmetry, softness, and sensation. The goal of this chapter is to assist in achieving these goals in the immediate breast reconstruction patient through the use of free autologous tissue transfers.

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Breast Reinnervation

Abstract: Supplemental Digital Content is available in the text.

Cited by 90 publications

References 16 publications

What does a breast feel like? A qualitative study among healthy women

What does a breast feel like? A qualitative study among healthy women

Dermatomal Somatosensory Evoked Potentials: An Indicator of Improvement of Breast Sensibility after Reduction Mammaplasty

Immediate Breast Reconstruction with Free Autologous Tissue Transfer

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