Nipple-areola complex sensitivity after primary breast augmentation: A comparison of periareolar and inframammary incision approaches

BACKGROUND: The body of literature documenting normative breast sensation and postoperative changes in sensation after reduction mammaplasty has grown considerably over the last several years. Despite this, only two studies have ever been published on the subject of postaugmentation mammaplasty sensory outcomes. The purpose of this study was to precisely measure sensory thresholds at the nipple-areola complex in women who have undergone augmentation mammaplasty by either the inframammary or periareolar approach. METHODS: Twenty women underwent primary augmentation mammaplasty by either the periareolar or inframammary approach at an average follow-up of 1.12 years. Sensory testing was performed using the Pressure-Specified Sensory Device by comparing moving and static sensory thresholds at the upper and lower areola and nipple. Nine women served as size-matched, nonoperated controls in the study. RESULTS: Primary augmentation mammaplasty was found to have a statistically significant negative effect on sensory outcomes when nonoperated controls were compared with women who had undergone augmentation mammaplasty via either the periareolar or inframammary approach. No differences in sensory outcomes were found between the two approaches used. Implant volume was found to be highly predictive of sensory outcomes, with an inverse relationship between implant size and the degree of sensitivity within the nipple-areola complex. CONCLUSIONS: Plastic surgeons should feel comfortable counseling patients that augmentation mammaplasty by either the inframammary or periareolar approach results in no discernible differences in sensory outcomes. Furthermore, women who choose very large implants relative to their breast skin envelopes should be warned about potential adverse sensory sequelae within the nipple-areola complex.