Loss of nipple areolar sensation after breast augmentation

For many women potential loss of nipple areolar sensation is one of their major concerns when considering breast augmentation.  Sensation in this area is critically important for a large number of women during sexual activity and thus any potential compromise of sensation in and around the nipple as a result of any breast surgical procedure needs to be carefully discussed during preoperative consultations.

Sensation to the nipple areolar complex usually comes from multiple nerve sources.  In most patients the major nerve providing sensation to this area is a branch of nerve traveling with the 4th thoracic rib.  This nerve comes off the rib on the lateral side of the breast then travels up inside the breast tissue mound to reach the nipple areolar area.  Other nerve branches travel from the more medial sternal and superior breast area to the nipple areolar region and supply additional sensation in varying amounts from patient to patient.

During breast augmentation the location of these nerves is well known to the surgeon and every effort is made to avoid injury.  Breast augmentation does require the careful development of either a subglandular or submuscular pocket for placement of the breast implant.  The larger implant that is chosen the more dissection that is required.

Some patients are concerned that choosing an infraareolar access incision may increase their chances for alteration of nipple areolar sensation.  This approach usually involves making an incision below the areolar and then tunneling away from the nipple to the lower edge of the breast to make the necessary pocket.  The infraareolar technique usually does not present any substantial increase for sensation loss.

Long term loss of nipple areolar sensation associated with breast augmentation should not be routinely expected but some degree of temporary sensory changes such as “tingling” can occur due to tissue stretch or swelling.  These temporary changes usually clear nicely over the first several weeks postoperatively.  I always explore the subject of possible sensory change with every prospective breast surgery patient.  Although the incidence of post operative sensory loss is small, every patient needs to thoroughly explore this subject with her surgeon during preoperative consultation.

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Classic Liposuction VS Laser Assisted Liposuction

Anyone browsing through one of the popular glossy women’s magazines can’t help but be bombarded by the advertising push to promote office based laser assisted liposuction procedures.  These ads make many clams such as “immediate results, less recovery time” and my personal favorite-“painless!”  Most products or services promoted in this manor naturally raise suspicions among the more skeptical population.

Laser assisted liposuction basically involves the placement of a small fiber optic wire below the skin to heat or “melt” the area of undesirable fat.  Once the fat has been heated by the laser light powered wire and reduced to a liquid, it is rolled or expressed out of the skin through a small hole.  This procedure is designed to be performed in an office setting under often no more than oral sedation.

Although laser assisted liposuction appears to be a scientifically valid concept.  I feel it may not be the most effective method of treatment for the majority of patients who present with fat excess (Lipodystrophy) problems.  In my private practice in Mansfield, Texas most patients I see in consultation have substantial fat deposits in the most common problem areas such as the abdomen, flank, thighs, and back.

To effectively and aggressively treat my average patient’s fat issues, I most often use either a conventional suction assisted liposuction or ultrasonic liposuction method.  Using these techniques, I can remove more adequate volumes of undesirable fat and substantially increase the odds of obtaining a more dramatic result for my patients. What I have found patients truly want are safe, predictable and dramatic results.  In my hands classic and ultrasonic liposuction methods offer the best chance to meet by patient’s desired goals.

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Love Handles

As we all get older our bodies change and our metabolism slows making it much easier to gain and retain fat weight.  Our body desperately wants to deposit this excess fat in certain patterns.  In women, the fat typically accumulates in the abdomen, hips and buttocks.  In men, the favorite spots are the abdomen and flanks or “love handles.”

Love handles are fortunately one of the most cooperative areas to treat by liposuction.  Successful liposuction of any body area depends on several factors.  One of the most critical factors is how well the skin remolds to the underlying body shape once the problem fat is removed.  In my experience, the skin in the love handle region remolds better than any other commonly treated area.

Because of the superior “cooperation” of the flanks or love handle areas to fat removal, surgeons can be more aggressive in treatment of these problem areas with less concern about unfavorable results because of poor skin re-contouring.  Aggressive liposuction of the love handle and lower back areas is a key ingredient in optimizing other procedures, such as tummy tucks (abdominoplasty) and buttock augmentation.  A tiny trim waist provides great contrast and naturally accentuates surrounding body features.  Please see my website or my other related blog articles for additional information and photographs.

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