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Sensitivity of the Nipple-Areola Complex and Sexual Function Following Reduction Mammaplasty
Edgard S Garcia1, Daniela F Veiga1, Miguel Sabino-Neto1
1Dr Garcia is a PhD Student in the Translational Surgery Graduate Program at the Universidade Federal de São Paulo - UNIFESP, Brazil, and a Medical Assistant Preceptor in the Division of Plastic Surgery at the Universidade do Vale do Sapucaí - UNIVÁS, Pouso Alegre, MG, Brazil. Dr Veiga is an Associate Professor in the Translational Surgery Graduate Program at the Universidade Federal de São Paulo - UNIFESP, Brazil, and a Medical Assistant Preceptor in the Division of Plastic Surgery at the Universidade do Vale do Sapucaí - UNIVÁS, Pouso Alegre, Brazil. Dr Sabino-Neto is an Associate Professor in the Translational Surgery Graduate Program at the Universidade Federal de São Paulo - UNIFESP, Brazil. Dr Beraldo-Cardoso is Psychologist and PhD in Translational Surgery at Universidade Federal de São Paulo - UNIFESP, Brazil. Drs Batista and Cabral are Residents in the Division of Plastic Surgery; Dr Leme is a Resident in the Division of Gynecology and Obstetrics; and Dr Novo is a Full Professor in the Department of Biostatistics of the Universidade do Vale do Sapucaí - UNIVÁS, Pouso Alegre, Brazil. Dr Ferreira is a Full Professor in the Division of Plastic Surgery and the Translational Surgery Graduate Program of the Universidade Federal de São Paulo - UNIFESP, Brazil.
Background:
The sensitivity of the nipple-areola complex (NAC) is very relevant to female sexuality.
Objective:
To evaluate NAC sensitivity and sexual function after breast reduction, and to assess whether altered NAC sensitivity is related to sexual dysfunction.
Methods:
The study included 80 patients, who were allocated to a control group with eutrophic breasts (CG, n = 20), a hypertrophy group without surgery (HG, n = 20), or a mammaplasty group (MG, n = 40). The MG was assessed preoperatively and 6 months postoperatively. The HG and CG were evaluated once. NAC sensitivity was assessed for touch, temperature, vibration, and pressure in four areola quadrants and the nipple. Sexual function was assessed with the Brazilian version of the Female Sexual Function Index, which has six domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and a total score that indicates the presence or absence of sexual dysfunction.
Results:
Compared to the CG, the MG had worse sensitivity to temperature and pressure in the nipple and areola medial quadrants postoperatively (P < 0.01). Compared to their preoperative assessment, the MG had reduced temperature and pressure sensitivity in the nipple and areola medial quadrants postoperatively (P < 0.05). Compared to the CG and HG, patients in the MG had higher postoperative scores of excitation (P = 0.0001), lubrication (P = 0.0004), orgasm (P < 0.0001), and satisfaction (P < 0.0001). There was an association between sexual dysfunction and low NAC sensitivity to temperature and vibration (P ≤ 0.041) in the MG's preoperative and postoperative scores, and to touch, temperature, and pressure across all three groups.
Conclusions:
Breast reduction with a superomedial pedicle reduced NAC sensitivity but did not interfere with sexual function.
