Breast Neurotization: Techniques, Outcomes, and Future Directions

The growing population of breast cancer survivors has increased the demand for breast reconstruction that restores not only shape but also sensory function. Neurotization techniques aiming to reestablish breast and nipple sensation have demonstrated promising outcomes, yet optimal approaches remain undefined. A scoping review of PubMed and EMBASE was conducted, focusing on studies of breast neurotization across autologous and implant-based reconstructions. Quantitative tools enable objective assessment of breast sensation across reconstruction types. Neurotization of autologous flaps improves recovery of protective and erogenous sensation and enhances physical well-being without adding significant surgical risk. Neurotization on implant-based breast reconstruction with nerve graft also showed promising sensory outcomes. Autografts support consistent nerve regeneration but are technically demanding; allografts simplify surgery and reduce morbidity but remain costly and underexplored. While preclinical data favor superficial neurotization, both superficial and deep approaches yield good clinical outcomes. Neurotization significantly improves postoperative sensation and patient-reported outcomes. Standardized prospective studies are needed to optimize technique selection and validate long-term benefits.