Immediate Targeted Nipple-Areolar Complex Reinnervation: Improving Outcomes in Gender-affirming Mastectomy

Plastic and Reconstructive Surgery. Global Open
Danielle H RochlinDung Nguyen

Abstract

Female-to-male mastectomy often renders the chest skin and nipple-areolar complex (NAC) insensate. We propose a new technique of preserving the intercostal nerves and using them to reinnervate the NAC after mastectomy. We performed a prospective analysis of transmasculine patients who underwent female-to-male mastectomy. The technique involves dissecting out the lateral intercostal nerves to length and performing a neurorrhaphy to nerve stumps at the base of the NAC. Sensory outcomes, as assessed with Semmes-Weinstein monofilaments, were compared to a cohort of patients who underwent mastectomy without neurotization. Ten patients with a mean age of 17.5 years (range: 16-19 years) underwent mastectomy. The final follow-up was a mean of 15.4 ± 4.3 months for the treated group and 40.7 ± 12.9 months for the control group. Compared to control patients, treated patients had significant improvement in sensation at the nipple (P ≤ 0.0002), areola (P = 0.0001), and peripheral breast skin (P = 0.0001). For treated patients, there was no statistically significant difference in sensation between preoperative and postoperative sensation in all tested areas at final follow-up. This proof of concept study suggests that immediate reinnervatio...Continue Reading

References

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Citations

Mar 21, 2021·Surgery·Arya Andre AkhavanAdeyemi A Ogunleye
Dec 21, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Ruth TevlinDung Nguyen

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