Evaluation of Permanent Nipple-Areola Complex Sensitivity Loss Following Reduction Mammoplasty.

Background: Predictors for permanent nipple-areola complex (NAC) insensitivity after reduction mammoplasty are sparsely defined.

Objectives: We analyze factors associated with NAC insensitivity over a long-term follow-up.

Methods: A retrospective analysis of reduction mammoplasties on 1598 breasts performed by four surgeons from March 2015-February 2023 was conducted. Data on patient demographics, intraoperative factors, and postoperative complications were collected from patient records. Analysis was conducted by breast, separated into breasts with NAC insensitivity (permanent and transient) and those without. Wilcoxon rank sum test for continuous variables and Fisher's exact test or Pearson's Chi-square test for categorical variables evaluated differences between the groups. Univariate and multivariate logistic regression analyzed the association of pedicle choice with NAC insensitivity onset and permanence.

Results: Of 1598 breasts, 9.8% had loss of NAC sensation, of which 49.0% had permanent loss. 51.0% regained sensitivity, taking an average of 116 days (median 64, range 6-798) to regain sensation. NAC-insensitive breasts had a longer sternal notch-NAC (p<0.001) and NAC-IMF (p<0.001) measurements, greater weight removed (p<0.001), and fat necrosis co-complication (p=0.022). Greater weight removed (p=0.044) and longer sternal notch-NAC measurements (p=0.011) were associated with permanent insensitivity. The superomedial pedicle was associated with an increased rate of transient NAC insensitivity, while the inferior pedicle with a decreased rate. There was no significant association between pedicle choices and permanent insensitivity.

Conclusions: Transient loss of NAC sensitivity is associated with pedicle choice, while breasts with permanent insensitivity were more likely to have longer breast measurements and a greater amount of tissue removed.