Comparing Nipple and Areola Sensory Outcomes and Nerve-Related Complications Using Different Incision Types in Breast...

Area of Science:

• Plastic Surgery
• Nipple-Areola Complex Sensation
• Surgical Incisions

Background:

• Nipple-areola complex sensation changes are a significant concern following breast augmentation surgery.
• Various incision techniques exist, including inframammary, periareolar, transareolar, transaxillary, and transumbilical, with unclear differential sensory impacts.
• This scoping review aims to synthesize existing evidence on the relationship between surgical incision type and nipple-areola outcomes, including nerve-related complications.

Purpose of the Study:

• To review and synthesize evidence on the sensory outcomes associated with different breast augmentation incision types.
• To compare the risks of nipple-areola complex sensory changes across various surgical approaches.
• To identify potential protective techniques and areas where further research is needed.

Main Methods:

• A comprehensive scoping review following PRISMA-ScR guidelines was conducted.
• Searches were performed across major databases (PubMed, Embase, Scopus, Cochrane, Google Scholar) up to July 2025.
• Studies reporting sensory outcomes stratified by incision type, using both subjective and objective measures, were included.

Main Results:

• Thirty-seven studies involving over 13,000 patients were analyzed.
• Periareolar incisions demonstrated a higher risk of hypoesthesia and pain compared to inframammary incisions in large cohorts.
• Lateralized inframammary incisions appeared to preserve sensation, while transumbilical incisions showed no nipple-areola complex changes; data for transaxillary and perinipple approaches were limited.

Conclusions:

• Surgical incision type significantly influences nipple sensation after breast augmentation, with technique and implant plane playing modifying roles.
• Periareolar incisions carry a higher risk of sensory alteration, whereas lateralized inframammary incisions may offer protection.
• Standardized, objective sensory testing is crucial for improving patient counseling and surgical planning.