What happens to the nerves during mastectomy?
During traditional mastectomy, nerves that serve the breast and nipple are cut as the breast tissue is removed, resulting in loss of sensation. This side effect is not often discussed between a woman and her breast surgeon, but the impact of sensation loss and breast numbness can be profound. In some cases, the numbness may spread across the entire chest area, creating an unnatural and unsettling effect for women after surgery.
Nerve sensation can be categorized four ways: Deep touch, light touch, pain, and temperature. Any type of sensation change can affect a woman in a variety of ways. In addition to losing pleasure sensation during intimacy, loss of pain and temperature sensations can increase a woman’s risk for injury to the breast. Women may bump their chest against objects without knowing it or even burn their breasts because they cannot detect heat in that area.
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How is a sensation-preserving mastectomy performed at our medical center?
Sensation-preserving mastectomy requires a highly specialized team that includes the oncologic surgeon to remove the cancerous tissue, and the plastic surgeon to reconstruct the breast and repair the severed nerves. A successful outcome requires these surgeons to work closely together during three critical stages.
During the first stage, our oncological breast surgeons Dr. Leslie Memsic and Dr. Heather Richardson carefully dissect the breast around the area of the intercostal nerves to remove the necessary breast tissue. After the breast tissue is removed from the nerve, our surgeons preserve the nerve root and protect it for the graft later.
During the next stage, the plastic surgeon performs breast reconstruction. To allow for sensation-preservation, the reconstruction must be done over the muscle, and ideally with a direct-to-implant process. In the final stage of the procedure, the plastic surgeon finds the recipient nerve under the areola/nipple complex, and anastomoses (connects) the nerve root to the nerve under the nipple using Axogen nerve tissue. By performing all three stages in a single session, our patients only have one recovery process.
Watch our video to see how our surgeons use nerve grafts to preserve sensation after breast cancer surgery.
What can I expect after my surgery?
Recovery after sensation-preserving mastectomy is similar to any other mastectomy procedure. You may spend 1-2 days with expert nursing care before going home, although some of our patients return home the same day as their surgery. You will be sore and tired for a time after your procedure and will need plenty of rest to allow your body to fully heal. Always contact our medical center if you experience any concerning side effects.
Most women return to their regular schedule within about four weeks, but this timeline varies from patient to patient. We will provide you with all the information you need to prepare for your surgery and recovery process once we are familiar with your unique case. We will also support you throughout your recovery process to ensure proper healing and minimize potential complications along the way.
How long will it take for sensation to return?
Once the nerves are reconnected, it takes time for them to regenerate and for sensation to return to the area. With sensation-preserving mastectomy, most patients can expect some return of sensation within 6 months post-op. Afterward, sensation can continue to spread throughout the breast and improve for up to another year.
Am I a candidate for sensation-preserving mastectomy?
Sensation-preserving mastectomy is an incredible option for women undergoing mastectomy who don’t want to lose feeling in their breasts. We can determine your specific candidacy based on the location and size of the cancer, as well as your expectations for your reconstruction results. Implant size may be limited for this procedure, based on your specific anatomy and goals.
Our surgeons will take the time to explore all of your avenues in breast reconstruction, including sensation-preserving mastectomy. As one of the only medical centers in Beverly Hills offering this procedure, our team has the level of expertise necessary to provide the best possible outcomes for our patients. You are never just a number at Bedford Breast Center – we work intimately with you to find the best path to your wholeness and healing.
– Bedford Breast Center
Leslie F. Memsic, MD, FACS
