Breast Neurotization
Peripheral Nerves in the Breast
Dr. Anne Peled reviews the history of sensation restoration and preservation.
Peripheral nerves are part of the nervous system that connect the brain and spinal cord to the rest of the body. These nerves are responsible for transmitting signals that allow us to feel, move, and perform vital functions. Peripheral nerves are made up of bundles of nerve fibers called axons, which are surrounded by a protective sheath called myelin. Damage to peripheral nerves can result in loss of sensation, weakness, or pain.
In the context of mastectomy, the sensory nerves that supply the breast are often cut or removed, leading to a permanent loss of feeling in the chest area. For many patients, this numbness can be distressing and impact their quality of life. However, recent advances in surgical reconstruction, particularly breast neurotization, aim to address this issue by restoring nerve function.
Can Surgeries Affect Breast Sensation?
Breast cancer is one of the most common cancers among women worldwide, and many patients undergo mastectomy as part of their treatment. While mastectomy can be life-saving, it often leaves patients with numbness and a lack of sensation in the chest area. This occurs because the surgery involves removing breast tissue along with nerves that supply sensation to the breast. Advances in surgical techniques, such as breast neurotization, offer hope in restoring sensation after mastectomy.
Dr. David Weintritt reviews the types of breast surgeries that can impact sensation.
Dr. Risal Djohan discusses how the anatomy of the breast can impact loss of sensation.
Dr. Anne Peled discusses the impact of sensation restoration.
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What is Breast Neurotization?
Breast neurotization is a surgical technique used during breast reconstruction to restore sensation to the chest area after mastectomy. This process involves connecting nerves from the chest wall or nearby areas to the reconstructed breast using nerve grafts or direct sutures. By re-establishing these neural connections, surgeons aim to promote the regeneration of nerve fibers into the new tissue, allowing patients to regain sensation over time.
One common approach to breast neurotization involves the use of autologous tissue reconstruction, such as the DIEP (deep inferior epigastric perforator) flap. In this procedure, tissue from the lower abdomen is used to reconstruct the breast, and nerves within this tissue can be connected to chest wall nerves to facilitate neurotization.
One common approach to breast neurotization involves the use of autologous tissue reconstruction, such as the DIEP (deep inferior epigastric perforator) flap. In this procedure, tissue from the lower abdomen is used to reconstruct the breast, and nerves within this tissue can be connected to chest wall nerves to facilitate neurotization.
Dr. Ziv Peled reviews the importance of saving and reconstruction of nerves
Alternatively, implant-based reconstruction can also incorporate neurotization techniques, although it is more challenging due to the lack of native tissue.
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Patient Perspectives and Quality of Life
Dr. Andrea Moreira discusses how patients are consulted on the loss or restoration of nerves.
The success of breast neurotization is not just measured by the return of sensation but also by its impact on patients’ overall well-being. Studies have shown that women who undergo neurotization report improved body image and emotional satisfaction compared to those without nerve reconstruction. The ability to feel touch in the reconstructed breast helps patients feel more connected to their bodies and can alleviate some of the emotional distress associated with mastectomy.
However, it is important for patients to have realistic expectations. Sensation recovery is often gradual, taking months to years, and the level of restored sensation can vary widely. Clear communication between patients and surgeons about the potential benefits and limitations of neurotization is essential.
PAGE CONTRIBUTORS
PAGE CONTRIBUTORS
Shafic Sraj, MD
Orthopadic Surgeon
University of West Virginia
West Virginia
University of West Virginia
West Virginia
Ziv Peled, MD
Plastic Surgeon
Peled Surgery
California
Andrea Moreira, MD
Associate Professor
University of Pittsburgh
Pennsylvania
Risal Djohan, MD
Plastic Surgeon
Cleveland Clinic
Ohio
Anne Peled, MD
Plastic Surgeon
Sutter Health
California
David Weintritt, MD
Breast Surgeon
Virginia Cancer Specialists
Virginia
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