Variability in Postoperative Nipple Sensation by Dermoglandular Pedicle in Bilateral Breast Reduction

IF 2 3区医学 Q2 SURGERY

Aesthetic Plastic Surgery Pub Date : 2024-09-20 DOI:10.1007/s00266-024-04331-4

Oluwaseun D. Adebagbo, Benjamin Rahmani, John B. Park, Amy Chen, Shannon R. Garvey, Daniela Lee, Bernard T. Lee, Nimish Saxena, Macie Gettings, Ashley Boustany, Samuel J. Lin, Ryan P. Cauley

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Abstract

Background

Decreased nipple sensation following reduction mammoplasty can negatively affect a variety of patient-centered outcomes. This observational study examined the impact of dermoglandular pedicle type on subjective postoperative nipple sensation.

Methods

A total of 178 women who underwent a bilateral reduction mammoplasty at a single institution from 2017 to 2023 and completed an 11-item survey assessing subjective postoperative nipple sensitivity across various tactile modalities were included. Patient-reported nipple sensations were compared across pedicle type and subgrouped by resection volume.

Results

Of the included survey respondents, 72% (128) underwent reduction with an inferior pedicle and 28% (50) with a superior or superomedial pedicle. Over 92% of patients reported the preservation of postoperative nipple sensation. Compared to the inferior pedicle, the superior pedicle cohort reported decreased nipple sensitivity to light touch (56% vs 30%, respectively) and temperature (30% vs 15%). In resection weights greater than 500 grams, the superior pedicle cohort was less satisfied with postoperative nipple sensation (84% vs. 58%), reported decreased sensation in light touch (58% vs 24%), pressure (50% vs 21%), and experienced more numbness and tingling (17% vs 1.4%) (all p-values ≤0.05).

Conclusion

The majority of patients maintain some sensation after reduction mammoplasty; however, approximately 10% reported a relative decrease in subjective nipple sensation. Pedicle choice did not significantly affect sensory recovery in resection weights of less than 500 grams. When a greater resection weight is anticipated, the inferior pedicle may be associated with more favorable nipple sensation outcomes.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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双侧乳房缩小术中真皮腺体基底层对乳头术后感觉的不同影响

背景：乳房缩小整形术后乳头感觉减退会对以患者为中心的各种结果产生负面影响。这项观察性研究探讨了真皮腺蒂类型对术后乳头主观感觉的影响：研究共纳入了 178 名女性，她们于 2017 年至 2023 年期间在一家机构接受了双侧乳房缩小整形术，并完成了一项由 11 个项目组成的调查，通过各种触觉方式评估术后乳头的主观敏感度。患者报告的乳头感觉在不同乳蒂类型中进行了比较，并按切除量进行了分组：在参与调查的受访者中，72%（128 人）接受了下蒂乳头缩小术，28%（50 人）接受了上蒂或上内侧蒂乳头缩小术。超过92%的患者表示术后保留了乳头感觉。与下蒂相比，上蒂患者的乳头对轻触（56% 对 30%）和温度（30% 对 15%）的敏感度降低。在切除重量大于 500 克的患者中，上蒂组对术后乳头感觉的满意度较低（84% 对 58%），轻触感下降（58% 对 24%），压力感下降（50% 对 21%），麻木和刺痛感增加（17% 对 1.4%）（所有 p 值均小于 0.05）：结论：大多数患者在乳房缩小整形术后仍能保持一定的感觉，但约有10%的患者报告乳头的主观感觉相对减弱。对于切除重量小于 500 克的患者，选择椎弓根对感觉恢复的影响不大。当预计切除重量较大时，下蒂可能与更有利的乳头感觉结果相关：本期刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整说明，请参阅目录或在线作者须知 www.springer.com/00266 。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.