J Korean Surg Soc.  2009 Feb;76(2):86-89. 10.4174/jkss.2009.76.2.86.

Sensory Loss of Upper Inner Arm and Nipple after Transaxillary and Periareolar Augmentation Mammaplasty - MDbP204

• Lee SD
• Oh JW
• Choi JH

• KMID: 2211259
• DOI: http://doi.org/10.4174/jkss.2009.76.2.86

Abstract

PURPOSE
Transaxillary and periareolar incision in augmentation mammaplasty has risks of injury to branches of intercostal nerves that lead to sensory loss of upper inner arm and nipple. The aim of study was to compare the incidence of sensory loss between two groups according to incision method.
METHODS
One hundred seventy one cases that received transaxillary or periareolar subpectoral breast augmentation at the M.D. Clinic from Jan. 2006 to Jul. 2007 were evaluated for sensory loss of upper inner arm and nipple. The cases were divided into transaxillary (118 cases, 69%) and periareolar group (53 cases, 31%). The type of sensory loss was divided into temporary and permanent. The postoperative follow-up periods were from 7 to 22 months (mean: 8.5 months).
RESULTS
In cases of upper inner arm, results were as follows; temporary sensory loss in 9 cases (7.6%) and permanent in 2 cases (1.7%) in the transaxillary incision group and, temporary sensory loss in 1 case (1.9%) and no permanent sensory loss in the periareolar incision group. There is no statistical difference between the two groups for permanent sensory loss (P=0.340). In cases of nipples, results were as follows; temporary sensory loss in 26 cases (22%) and permanent sensory loss in 12 cases (10.2%) in the transaxillary incision group, and temporary sensory loss in 12 cases (10.2%) and permanent sensory loss in 3 cases (5.7%) in the periareolar incision group. There was no statistical difference between two groups (P=0.335).
CONCLUSION
There was no statistical difference in sensory loss of upper arm and nipple between transaxillary and periareolar approach after subpectoral augmentation mammaplasty.

Keyword

Sensory loss; Upper inner arm; Nipple; Augmentation mammaplasty

MeSH Terms

Arm
Breast
Female
Follow-Up Studies
Incidence
Intercostal Nerves
Mammaplasty
Nipples

Figure

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  Fig. 1 Transaxillary (A) and periareolar (B) incision.

Reference

1. Courtiss EH, Goldwyn RM. Breast sensation before and after plastic surgery. Plast Reconstr Surg. 1976. 58:1–13.

2. Farina MA, Newby BG, Alani HM. Innervation of the nipple-areola complex. Plast Reconstr Surg. 1980. 66:497–501.

3. Planas J. Mammary augmentation--surgical techniques, evaluation of results, and complications. Clin Plast Surg. 1976. 3:233–246.

4. Mofid MM, Klatsky SA, Singh NK, Nahabedian MY. Nipple-areola complex sensitivity after primary breast augmentation: a comparison of periareolar and inframammary incision approaches. Plast Reconstr Surg. 2006. 117:1694–1698.

5. Okwueze MI, Spear ME, Zwyghuizen AM, Braun SA, Ajmal N, Nanney LB, et al. Effect of augmentation mammaplasty on breast sensation. Plast Reconstr Surg. 2006. 117:73–83.

6. Lee S. Complications and reasons for dissatisfaction in augmentation mammoplasty: analysis of 42 cases of re-operation. J Korean Breast Cancer Soc. 2004. 7:121–125.

7. Ghaderi B, Hoenig JM, Dado D, Angelats J, Vandevender D. Incidence of intercostobrachial nerve injury after transaxillary breast augmentation. Aesthet Surg J. 2002. 22:26–32.

8. Tebbetts JB. Transaxillary subpectoral augmentation mammaplasty: long-term follow-up and refinements. Plast Reconstr Surg. 1984. 74:636–649.

9. Temple WJ, Ketcham AS. Preservation of the intercostobrachial nerve during axillary dissection for breast cancer. Am J Surg. 1985. 150:585–588.

10. Hoehler H. Breast augmentation: the axillary approach. Br J Plast Surg. 1973. 26:373–376.

11. Munhoz AM, Fells K, Arruda E, Montag E, Okada A, Aldrighi C, et al. Subfascial transaxillary breast augmentation without endoscopic assistance: technical aspects and outcome. Aesthetic Plast Surg. 2006. 30:503–512.

12. Tebbetts JB. Transaxillary subpectoral augmentation mammaplasty: a 9-year experience. Clin Plast Surg. 1988. 15:557–568.

13. Hetter GP. Satisfactions and dissatisfactions of patients with augmentation mammaplasty. Plast Reconstr Surg. 1979. 64:151–155.

14. Hwang K, Jung CY, Lee WJ, Chung IH. The lateral cutaneous branch of the fourth intercostal nerve relating to transaxillary augmentation mammoplasty. Ann Plast Surg. 2004. 53:27–30.

15. Banbury J, Yetman R, Lucas A, Papay F, Graves K, Zins JE. Prospective analysis of the outcome of subpectoral breast augmentation: sensory changes, muscle function, and body image. Plast Reconstr Surg. 2004. 113:701–707.

16. Schreiber J, Girotto J, Mofid M, Singh N, Nahabedian M. Comparison study of nipple-areolar sensation after reduction mammaplasty. Aesthet Surg J. 2004. 24:320–323.