Breast reinnervation surgery is a new, advanced technique aiming to restore protective and tactile sensation to the breast and nipple-areola complex, while also minimizing the risk of post-mastectomy pain from symptomatic neuromas. Your body normally has multiple intercostal nerves that run along the muscles of your chest wall and then travel through your breast gland to provide sensation to the breast skin and nipple-areola complex. Unfortunately, during a mastectomy, these nerves have to be cut in order to remove the breast, causing decreased sensation and increasing the risk that the cut nerve ends become painful neuromas. Breast reinnervation surgery strives to restore some of the lost sensation.

Overview & Why Choose Dr. Chang

Breast Reinnervation

  • Patients Undergoing Nipple-Sparing Mastectomy – Almost all patients undergoing nipple-sparing mastectomy are candidates for this surgery. Patients undergoing both implant and autologous reconstruction in immediate and delayed fashion are eligible. The goal in these patients is to re-innervate your nipple-areola complex.

  • Patients Undergoing Skin-Sparing Mastectomy with Autologous Reconstruction with DIEP Flaps – Almost all patients undergoing skin sparing mastectomy with autologous reconstruction with DIEP flaps are candidates for this surgery. The goal in these patients is to reinnervate the flap.

  • Insurance Coverage – Unfortunately, because this is a newly developed technique, not all insurance companies agree to cover breast re-innervation surgery. In order to perform this surgery, cadaveric nerve grafts must be used, the cost of which has to be covered by your insurance company.


Who Is a Candidate for Breast Reinnervation?

Dr. Chang assists in the final portion of the mastectomy in order to identify the intercostal nerves that provide sensation to your breasts. These nerves are dissected away from the breast in order to preserve as much normal length of your nerves. For patients undergoing nipple-sparing mastectomy, a cadaveric nerve graft is sutured to the cut end of the intercostal nerve and to the undersurface of your nipple areola complex. For patients undergoing skin-sparing mastectomy, a cadaveric nerve graft is sutured to the cut end of the intercostal nerve and to a sensory nerve in your DIEP flap. Tissue glue is used to help reinforce and protect the nerve coaptations.

How Is Breast Reinnervation Surgery Performed?

This is not a risk of breast reinnervation surgery itself but rather of a mastectomy. When the intercostal nerves are cut, they try to regenerate by sprouting like a plant bud. Sometimes, this process is very controlled and allows one to regain sensation. Sometimes, this process is very uncontrolled and your body forms excessive scar tissue around the cut end of the nerve. This nerve scar is called a neuroma and can become very painful.

Post-Mastectomy Pain

The biggest risk of this procedure is that it fails to return any sensation to your breast. All patients regain some protective sensation over time, but sometimes the nerve repairs fail to provide additional sensation on top of that. Depending on the length of graft used, it will take 6-12 months for us to determine if you will regain sensation, as that is how long it takes for your body’s nerves to regenerate and grow along the nerve graft.

Re-innervation Failure

Risks of Breast Reinnervation Surgery

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