Sensation Following Immediate Breast Reconstruction with Implants

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Sensory Neuroscience

Background:

• Sensation is a critical yet often overlooked outcome in breast reconstruction.
• Assessing sensory changes after mastectomy and implant-based reconstruction is essential for patient satisfaction.

Purpose of the Study:

• To prospectively evaluate cutaneous somatosensory status after mastectomy and immediate breast reconstruction with adjustable prostheses.
• To analyze patients' subjective experiences of sensation in the reconstructed breast.

Main Methods:

• Quantitative somatosensory testing (touch, cold, warmth, heat pain perception thresholds) in 24 patients.
• Preoperative and 2-year postoperative assessments using Von Frey filaments and a thermode.
• Patient questionnaires on subjective sensory experience.

Main Results:

• Significant impairment in all tested sensory modalities compared to preoperative levels, most pronounced above the areola.
• No significant difference in sensation based on whether patients received postoperative radiotherapy.
• All patients reported reduced sensation; 70% felt the reconstructed breast was real, though 96% noted it felt different from the contralateral breast.

Conclusions:

• Mastectomy and immediate implant reconstruction lead to measurable sensory deficits.
• Preoperative counseling on expected sensory changes is crucial for managing patient expectations.
• A majority of patients achieve a subjective sense of realism in their reconstructed breast, a key goal of the procedure.