Late Sensory Neurotization of the Nipple-Areola Complex after Implant-Based Breast Reconstruction

Background: Nipple-sparing mastectomy (NSM) has become widely adopted owing to its oncologic safety, aesthetic results and psychological benefits. Lack of sensation on the Nipple-areola complex (NAC) after reconstruction remains a common complaint that has been scarcely researched in the alloplastic reconstruction population. The aim of this report is to present a nipple neurotization technique suitable for patients undergoing implant-based breast reconstruction. Case Presentation: A ۴۲-year-old female with ductal breast carcinoma underwent periareolar NSM with implant-based reconstruction and complained about lack of tactile sensation on mastectomy flaps and NAC. A year after the reconstruction surgery, she underwent late NAC neurotization by bridging the ۴th intercostal nerve to the undersurface of the areola using a ۱۵cm sural nerve autograft. Recovery of protective and pressure sensation was seen six months later over the NAC. Conclusion: This case confirms that late neurotization in alloplastic reconstruction by bridging the areolar dermis to a donor intercostal nerve provides sensory recovery at the NAC.

Keywords:

Nipple areola complex , intercostal nerves , breast implants , sensory recovery