Adebagbo Oluwaseun D, Rahmani Benjamin, Park John B, Chen Amy, Garvey Shannon R, Lee Daniela, Lee Bernard T, Saxena Nimish, Gettings Macie, Boustany Ashley, Lin Samuel J, Cauley Ryan P
Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, LMOB 5A, Boston, MA, 02215, USA.
Tufts University School of Medicine, Boston, MA, USA.
Aesthetic Plast Surg. 2025 Feb;49(3):769-778. doi: 10.1007/s00266-024-04331-4. Epub 2024 Sep 20.
Decreased nipple sensation following reduction mammoplasty can negatively affect a variety of patient-centered outcomes. This observational study examined the impact of dermoglandular pedicle type on subjective postoperative nipple sensation.
A total of 178 women who underwent a bilateral reduction mammoplasty at a single institution from 2017 to 2023 and completed an 11-item survey assessing subjective postoperative nipple sensitivity across various tactile modalities were included. Patient-reported nipple sensations were compared across pedicle type and subgrouped by resection volume.
Of the included survey respondents, 72% (128) underwent reduction with an inferior pedicle and 28% (50) with a superior or superomedial pedicle. Over 92% of patients reported the preservation of postoperative nipple sensation. Compared to the inferior pedicle, the superior pedicle cohort reported decreased nipple sensitivity to light touch (56% vs 30%, respectively) and temperature (30% vs 15%). In resection weights greater than 500 grams, the superior pedicle cohort was less satisfied with postoperative nipple sensation (84% vs. 58%), reported decreased sensation in light touch (58% vs 24%), pressure (50% vs 21%), and experienced more numbness and tingling (17% vs 1.4%) (all p-values ≤0.05).
The majority of patients maintain some sensation after reduction mammoplasty; however, approximately 10% reported a relative decrease in subjective nipple sensation. Pedicle choice did not significantly affect sensory recovery in resection weights of less than 500 grams. When a greater resection weight is anticipated, the inferior pedicle may be associated with more favorable nipple sensation outcomes.
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乳房缩小成形术后乳头感觉减退会对多种以患者为中心的结局产生负面影响。本观察性研究探讨了真皮腺体蒂类型对术后主观乳头感觉的影响。
纳入2017年至2023年在单一机构接受双侧乳房缩小成形术并完成一项11项调查的178名女性，该调查评估了术后乳头在各种触觉模式下的主观敏感性。比较不同蒂类型患者报告的乳头感觉，并按切除量进行亚组分析。
在纳入调查的受访者中，72%（128例）采用下蒂法进行乳房缩小术，28%（50例）采用上蒂或上内侧蒂法。超过92%的患者报告术后乳头感觉得以保留。与下蒂法相比，上蒂法组患者报告对轻触（分别为56%对30%）和温度（30%对15%）的乳头敏感性降低。在切除重量大于500克时，上蒂法组患者对术后乳头感觉的满意度较低（84%对58%），报告轻触（58%对24%）、压力（50%对21%）感觉降低，且麻木和刺痛感更多（17%对1.4%）（所有p值≤0.05）。
大多数患者在乳房缩小成形术后仍保留一定感觉；然而，约10%的患者报告主观乳头感觉相对下降。在切除重量小于500克时，蒂的选择对感觉恢复无显著影响。当预期切除重量较大时，下蒂法可能与更有利的乳头感觉结局相关。
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