Because most of the nerves that provide sensation to the skin and tissue of the breast travel directly within the breast tissue, removal of the breast by mastectomy unavoidably causes loss of sensation and numbness to the breast area. Women undergoing mastectomy should understand they will lose feeling in the area, regardless of whether they choose to have breast reconstruction or not. Women must also understand that nipple-preserving mastectomy preserves the physical structure of the nipple and areola, however the unique sensation associated with these structures is permanently lost following mastectomy.
Over a period of one to two years following mastectomy, some women experience return of some degree of sensation in the breast area, but for many patients minimal, if any, sensation ever spontaneously returns. Women who have natural tissue reconstruction generally experience a greater degree of sensation returning over time because nerve endings can grow within natural tissue, while implants represent a barrier to nerve growth.
Women who chose to have their breast reconstructed using their own tissue may be candidates for an additional procedure called “microneurorrhaphy.” Microneurorrhaphy connects a nerve in the tissue being used to restore the breast to a cut nerve at the mastectomy. This procedure, which is only possible with natural-tissue breast reconstruction, can improve the return of sensation to the breast. While it is not always possible to perform a microneurorrhaphy, when possible, we believe doing so helps to restore an important dimension of what having a breast reconstructed means.