Francalancia Stephanie, Lou Mary, McIntire Damon, Sobti Nikhil, Barrow Brooke, Marquez-Garcia Josué, Kwan Daniel, Sullivan Rachel, Liu Paul, Breuing Karl
Aesthet Surg J. 2025 Jan 16;45(2):NP50-NP56. doi: 10.1093/asj/sjae215.
Predictors for permanent nipple-areolar complex (NAC) insensitivity after reduction mammaplasty are sparsely defined.
We analyzed factors associated with NAC insensitivity over long-term follow-up.
A retrospective analysis of reduction mammaplasties on 1598 breasts performed by 4 surgeons from March 2015 to February 2023 was conducted. Data on patient demographics, intraoperative factors, and postoperative complications were collected from patient records. Analysis was conducted by breast, separated into breasts with NAC insensitivity (permanent and transient) and those without. Wilcoxon rank sum test for continuous variables and Fisher's exact test or Pearson's chi-square test for categorical variables evaluated differences between the groups. Univariate and multivariate logistic regression analyzed the association of pedicle choice with NAC insensitivity onset and permanence.
Of 1598 breasts, 9.8% had loss of NAC sensation, of which 49.0% had permanent loss. A total of 51.0% regained sensitivity, taking an average of 116 days (median 64, range 6-798) to regain sensation. NAC-insensitive breasts had longer sternal notch to NAC (P < .001) and NAC to IMF (P < .001) measurements, greater weight removed (P < .001), and fat necrosis co-complication (P = .022). Greater weight removed (P = .044) and longer sternal notch to NAC measurements (P = .011) were associated with permanent insensitivity. The superomedial pedicle was associated with an increased rate of transient NAC insensitivity, whereas the inferior pedicle had a decreased rate. There was no significant association between pedicle choices and permanent insensitivity.
Transient loss of NAC sensitivity is associated with pedicle choice, and breasts with permanent insensitivity were more likely to have longer breast measurements and a greater amount of tissue removed.
乳房缩小成形术后永久性乳头乳晕复合体（NAC）感觉丧失的预测因素定义尚不明确。
我们分析了长期随访中与NAC感觉丧失相关的因素。
对2015年3月至2023年2月期间4位外科医生进行的1598例乳房缩小成形术进行回顾性分析。从患者记录中收集患者人口统计学、术中因素和术后并发症的数据。按乳房进行分析，分为有NAC感觉丧失（永久性和暂时性）的乳房和无感觉丧失的乳房。连续变量采用Wilcoxon秩和检验，分类变量采用Fisher精确检验或Pearson卡方检验评估组间差异。单因素和多因素逻辑回归分析蒂的选择与NAC感觉丧失的发生和永久性之间的关联。
在1598例乳房中，9.8%出现NAC感觉丧失，其中49.0%为永久性丧失。共有51.0%恢复了感觉，平均需要116天（中位数64天，范围6 - 798天）恢复感觉。对NAC不敏感的乳房，胸骨切迹至NAC（P < .001）和NAC至乳房下皱襞（P < .001）的测量值更长，切除的重量更大（P < .001），且有脂肪坏死合并症（P = .022）。切除重量更大（P = .044）和胸骨切迹至NAC测量值更长（P = .011）与永久性感觉丧失相关。上内侧蒂与暂时性NAC感觉丧失率增加相关，而下蒂则降低。蒂的选择与永久性感觉丧失之间无显著关联。
NAC感觉的暂时性丧失与蒂的选择有关，永久性感觉丧失的乳房更可能乳房测量值更长且切除的组织量更大。
