Sensation Alterations Following Superior and Superomedial Wise Pattern Breast Reductions

Breast reduction has the potential to alter sensation of the breast and nipple-areolar complex (NAC) due to intraoperative sensory nerve disruption. There is currently a paucity of available literature pertaining to sensation changes following reduction, and the results are inconclusive due to variability of the findings. This study aims to assess sensation changes following superior and superomedial Wise pattern reduction, as well as any potential impact on patient satisfaction.

Sensation was tested using the AcroVal pressure-specified sensory device in nine regions of the breast: the outer superior, outer medial, outer inferior (OI), outer lateral, inner superior, inner medial, inner inferior, inner lateral, and the NAC. Sensation was compared between preoperative measurements and postoperative measurements between 0-3 months and 6-12 months. Patients also completed the BREAST-Q Reduction/Mastopexy Module preoperatively and postoperatively.

Thirty-seven preoperative measurements on 74 breasts and 34 postoperative measurements on 67 breasts were conducted. Patients experienced a significant decrease in NAC sensation between 0-3 months postoperatively (P < 0.05); however, this returned to baseline between 6-12 months postoperatively. Preoperatively, the OI region showed significantly reduced sensation compared all other regions of the breast and the NAC at baseline (P < 0.05). Postoperatively, the entire inferior region (inner inferior and OI) showed worse sensation than the majority of the other regions of the breast and a significant reduction from preoperative sensation (P < 0.05). The only region that gained sensation postoperatively was the outer medial region at 6-12 months postoperative (P < 0.05).BREAST-Q scores showed significant improvement in psychosocial and physical well-being, and satisfaction with breasts (P < 0.05), and a positive trend in sexual well-being.

Following breast reduction with the superior or superomedial pedicle, patients may experience a transient reduction in NAC sensation which returns to baseline by 6-12 months postoperatively. Patients with large breasts may have reduced sensation in the OI region at baseline, and the inferior region will continue to have worse sensation compared to the other regions postoperatively and will even experience further reduction in sensation compared to baseline. Despite these sensation alterations, patients experienced an overall improvement in well-being and satisfaction.