Late Sensory Neurotization of the Nipple-Areola Complex After Implant-Based Breast Reconstruction NAC neurotization late after Implant base IBR

Jose Telich-Tarriba (1), Daniel Garza-Arriaga (2), David Navarro-Barquin (3), Alejandro Lopez-Garibay (4), Alexander Cardenas-Mejia (5)
(1) Plastic and Reconstructive Surgery Department, Hospital Angeles Pedregal, Mexico City, Mexico , Mexico,
(2) Breast Reconstruction Department, Fundación de Cáncer de Mama, Mexico City, Mexico, Mexico,
(3) Plastic and Reconstructive Surgery Division, Hospital General “Dr. Manuel Gea Gonzalez”, Mexico City, Mexico, Mexico,
(4) Plastic and Reconstructive Surgery Division, Hospital General “Dr. Manuel Gea Gonzalez”, Mexico City, Mexico, Mexico,
(5) Plastic and Reconstructive Surgery Division, Hospital General “Dr. Manuel Gea Gonzalez”, Mexico City, Mexico, Mexico

Abstract

Background: Nipple-sparing mastectomy (NSM) has become widely adopted owing to its oncologic safety, aesthetic results and psychological benefits. Lack of sensation on the Nipple-areola complex (NAC) after reconstruction remains a common complaint that has been scarcely researched in the alloplastic reconstruction population. The aim of this report is to present a nipple neurotization technique suitable for patients undergoing implant-based breast reconstruction.
Case Presentation: A 42-year-old female with ductal breast carcinoma underwent periareolar NSM with implant-based reconstruction and complained about lack of tactile sensation on mastectomy flaps and NAC. A year after the reconstruction surgery, she underwent late NAC neurotization by bridging the 4th intercostal nerve to the undersurface of the areola using a 15cm sural nerve autograft. Recovery of protective and pressure sensation was seen six months later over the NAC.
Conclusion: This case confirms that late neurotization in alloplastic reconstruction by bridging the areolar dermis to a donor intercostal nerve provides sensory recovery at the NAC.

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Authors

Jose Telich-Tarriba
josetelich@gmail.com (Primary Contact)
Daniel Garza-Arriaga
David Navarro-Barquin
Alejandro Lopez-Garibay
Alexander Cardenas-Mejia
1.
Telich-Tarriba J, Garza-Arriaga D, Navarro-Barquin D, Lopez-Garibay A, Cardenas-Mejia A. Late Sensory Neurotization of the Nipple-Areola Complex After Implant-Based Breast Reconstruction: NAC neurotization late after Implant base IBR. Arch Breast Cancer [Internet]. 2022 Mar. 10 [cited 2024 Apr. 23];9(2):247-9. Available from: https://archbreastcancer.com/index.php/abc/article/view/536

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