Will My Nipples Lose Sensation After Breast Surgery?

One of the most common questions women have about breast surgeries is whether their nipples will lose sensation.

The answer varies widely, depending on the type of procedure you have. For mastectomies and breast reconstruction, it is highly likely that there will be lost sensitivity. But with breast augmentation, losing sensitivity is far less likely.

To better understand how these surgeries can affect you, let’s take a closer look at how your nipples work.

Complex Array of Nerves

Certain parts of our bodies have more nerve endings than others. For example, we have an extremely high concentration of nerve endings in our fingertips, lips and tongue. Your nipples and areola do not have as many, yet there are hundreds of nerve endings found in that region, making them extremely sensitive to touch and sexual arousal. 

This complex array of nerves travels out of your chest wall and through your breast tissue – following patterns that differ from person to person – before ending at the nipple and areola. This makes it difficult to isolate and protect those nerves during any procedure that involves substantial removal of tissue from the breast. It is inevitable those nerve endings will be severed during a mastectomy.

Fortunately, there has been progress in developing procedures with the potential to restore at least some of that lost sensation. Traditionally, doctors have focused on restoring the shape of the breast – without the feeling and function. Breastfeeding function will not recover after a mastectomy, but having sensitivity restored is important for many women. The procedure, called breast neurotization, is becoming more common. It’s a new frontier offering hope for reconstruction patients as more insurance companies get on board with it.

Breast Cancer Surgeries

Surgeries to treat breast cancer represent the most significant threat to nipple sensation. During a mastectomy, the nipple and areola are often removed during the procedure. But during a lumpectomy (also known as breast-conserving surgery), your surgeon removes only the tumor and a bit of surrounding healthy tissue. There is a much better chance of preserving sensitivity, depending on the size of the tumor and location. Numbness in part of the breast is not uncommon, but often the feeling returns, at least partially, over time.

For some women, a nipple-sparing mastectomy is an option. With this procedure, the nipple and areola are left intact, along with breast skin, and tested for cancer. If no cancer is detected, the nipple and areola are included in the subsequent breast reconstruction.

The procedure may be an option for patients who do not have these characteristics:

• Multiple tumors in the same breast quadrant
• Multiple tumors, but spread across several breast quadrants
• Invasive tumors and large areas of ductal carcinoma in situ, a condition that affects the cells of the milk ducts
• Tumor bigger is 3 centimeters
• Tumor located less than 2 centimeters from the nipple/areola

Even with this procedure, total loss of nipple sensitivity can occur because of the number of nerves severed. While some women do experience a gradual return of some sensitivity over time (nerves tend to heal very slowly), loss of sensation after mastectomy is expected.

Breast Augmentation, Lifts and Reductions

Outcomes are quite different with breast augmentation procedures. In general, loss of nipple sensitivity occurs in about 10 percent of these surgeries. The risk can be modified by several factors:

• Implant size: Larger implants are more likely to stretch tissue and associated nerves linked to the nipples.
• Incision site: The most common incision locations are the crease under the breast, around the areola or the underarm area. Not surprisingly, cuts around the areola are more likely to contribute to lost sensitivity.
• Implant placement: The best results, in terms of lost sensitivity, occur when the implant is placed behind the pectoral muscle.

With breast reduction and lifts, much depends on the amount of tissue that’s being removed. It’s common to experience considerable loss of nipple sensation after these procedures. Only about 10 percent of women recover sensitivity over the following six to 12 months.

For cosmetic procedures, this is an important element of pre-operative counseling. If it’s something you are considering, you should be aware that there is at least some risk of losing all or part of the sensation in your nipples.