Breast Neurotization: Techniques, Outcomes, and Future Directions

Area of Science:

• Reconstructive surgery
• Neuroscience
• Oncology

Background:

• Increasing breast cancer survivor population necessitates improved reconstruction beyond aesthetics.
• Restoring sensory function is a key unmet need in breast reconstruction.
• Neurotization techniques offer potential for reestablishing breast and nipple sensation.

Purpose of the Study:

• To conduct a scoping review of neurotization in breast reconstruction.
• To evaluate outcomes of neurotization in both autologous and implant-based reconstructions.
• To identify optimal approaches for sensory restoration in breast reconstruction.

Main Methods:

• Scoping review of PubMed and EMBASE databases.
• Inclusion of studies on breast neurotization in autologous and implant reconstructions.
• Utilized quantitative tools for objective sensation assessment.

Main Results:

• Neurotization of autologous flaps improves protective and erogenous sensation and well-being.
• Implant-based reconstruction with nerve grafts shows promising sensory outcomes.
• Both superficial and deep neurotization approaches yield good clinical results, with autografts offering consistent regeneration but higher technical demand.

Conclusions:

• Neurotization significantly enhances postoperative sensation and patient-reported outcomes.
• Autografts and allografts present different trade-offs in terms of surgical complexity and cost.
• Standardized prospective studies are essential to optimize neurotization techniques and validate long-term benefits.