And other Sensory Changes

Dr. Loftus provide you with important information about the risk of the loss of nipple sensation after breast augmentation surgery, how often the lost feeling may occur, and how to obtain increased feeling to the nipple again. Your nipple and/or breast skin might lose sensation partially or completely following augmentation. As the nerve that conducts sensation to the nipple is typically small and thin, surgeons often do not see it during surgery. As such, it might be stretched, cut, or inadvertently cauterized. If stretched, sensation usually returns. If it is cut, sensation usually does not return. If cauterized (burned), the likelihood of sensory return depends upon the extent of cautery.

The risk of permanent nipple numbness is about 15% nationally. If loss of nipple sensation is unacceptable to you, you should carefully reconsider this operation. Another option is to ask your surgeon to avoid cautery near the nerve and to use only finger dissection which confers a lower rate of nipple numbness.

Implant size and implant position may influence your risk of nipple numbness after breast augmentation surgery. Selecting an implant which has a diameter larger than that of your breast will increase the likelihood of nipple numbness. For example, a woman with an 11 cm diameter breast who chooses a 13 cm diameter implant (about 400 cc) is more likely to have nipple numbness than a woman with a 15 cm diameter breast who chooses a 14 cm diameter implant (about 500 cc). So, this is a relative issue. Implants placed under the muscle have a lower rate of nipple numbness than implants placed above the muscle.

If you do develop nipple numbness after surgery, sensation may take up to 2 years to return. You may facilitate a sooner and more complete return of sensation by massaging your nipples and breast skin regularly. This involves light touch with your fingers for several minutes several times each day. Some women mistakenly believe that light touch from their significant other works just as well, but it does not. You must perform your own light touch, as doing so reinforces neural pathways within your brain and facilitates sensory return.

The opposite problem, increased nipple sensation, is also possible and can be very aggravating. If so, it usually resolves within a few weeks. Here again, massage is very important.

Sharp shooting pains sometimes occur, especially as nipple sensation is returning. Here again, massage is critical, as doing so will reduce unpleasant feelings and reinstate normal sensation.

Breast augmentation does not usually affect nipple erection, which is preserved even if sensation is lost.