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Advanced Techniques Used in Tandem Microsurgery Return Sensation to Nipples Post-Mastectomy

December 26, 2024

Highly skilled and extensively trained microsurgeons with Orlando Health have helped reestablish nipple sensation in more than 50 cancer patients undergoing reconstructive surgery following a mastectomy. Using novel microsurgical techniques, breast and plastic surgeons work collaboratively during a mastectomy to preserve and reconstruct breast nerves, reattaching them behind the nipple after the mastectomy is complete.

Kenneth R. Lee, MD
Kenneth R. Lee, MD

“We are one of the first centers to offer this procedure to our nipple-sparing mastectomy patients,” says Kenneth Lee, MD, chief of plastic and reconstructive surgery at Orlando Health Cancer Institute and a board-certified plastic surgeon with Orlando Health Aesthetic and Reconstructive Surgery Institute. Dr. Lee also is one of the few surgeons to routinely perform neurotized DIEP flap procedures to restore physical sensation in bilateral breast reconstruction.

Historically, the nerves to the skin, nipple and areola are sacrificed during mastectomy, resulting in breast and nipple numbness.  “Nipple re-sensation surgery helps salvage that aspect of patient recovery,” says surgeon Jeffrey Smith, MD, chief of the breast oncology program at Orlando Health Cancer Institute.

Jeffrey Smith, MD
Jeffrey Smith, MD

Dr. Smith and his team work in tandem with Dr. Lee, tailoring the surgical approach to spare as much of the breast’s skin as possible, including the nipple and areola. Using advanced microsurgical techniques, nerve segments at the chest wall are identified and dissected in 1 to 3 centimeter segments. The spared nerve segments are then used in neurotization, reestablishing the connection between the patient’s lateral intercostal nerves back to an end target behind the nipple.

“Over time, the nerve regenerates and reconnects to return sensation to the nipple,” says Dr. Lee, whose early data shows re-sensation results ranging from protective skin sensation to sexual sensation. “The satisfaction rate for patients is extremely high.”

Surgical collaboration and a multidisciplinary team approach across institutes benefit patients. “It’s really our strength at Orlando Health,” says Dr. Smith. “It’s a coordinated dance when we work together in the operating room to treat cancer while at the same time providing the best aesthetic outcome.”

Plastic and reconstructive microsurgeons at Orlando Health Aesthetic and Reconstructive Surgery Institute specialize in complex breast reconstruction and collaborative multidisciplinary patient care. Orlando Health Cancer Institute offers leading-edge therapies and an evidence-based approach for each patient’s specific type and stage of cancer.

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