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Targeted Nipple Areola Complex Reinnervation in Gynecomastia Mastectomy: A Case Report
Elizabeth E Blears1, Katya Remy2, Silviu Diaconu2
1Department of Plastic & Reconstructive Surgery, Tower Health Hospital System, West Reading, Pennsylvania, USA.
Microsurgery
|April 3, 2025
Summary
Targeted nipple areola complex (NAC) reinnervation successfully restored sensation after mastectomy for gynecomastia in a male patient. This technique achieved high patient satisfaction with sensory function and minimal adverse effects.
Area of Science:
- Plastic Surgery
- Regenerative Medicine
- Neuroscience
Background:
- Gynecomastia and chest wall laxity can necessitate mastectomy.
- Restoring nipple and chest sensation after mastectomy is a clinical challenge.
- Targeted nipple areola complex (NAC) reinnervation (TNR) is a technique to restore sensation.
Observation:
- A 32-year-old male with gynecomastia underwent bilateral mastectomy with free nipple grafting.
- Three lateral intercostal nerves were coaptated to the new NAC on each side.
- Sensory evaluation at 18 months included monofilament detection, pressure pain threshold, and two-point discrimination.
Findings:
- The patient reported "very satisfied" with nipple and chest sensation.
- Quantitative sensory tests showed restored sensation at the NAC and chest wall.
- No significant hypersensitivity, pain, or phantom sensations were reported.
Implications:
- TNR can effectively restore quantitative and patient-reported sensory functions after mastectomy for gynecomastia.
- This study presents the first quantitative sensory outcomes of TNR in a male patient for gynecomastia treatment.
- TNR offers a promising solution for improving patient outcomes and satisfaction following chest reconstruction.
