Lin Walter, Titan Ashley, Doucet Veronique, Pridgen Brian, Safa Bauback
From The Buncke Clinic, San Francisco, CA.
Department of Surgery, Division of Plastic Surgery, Stanford University, Stanford, CA.
Plast Reconstr Surg Glob Open. 2025 Mar 3;13(3):e6565. doi: 10.1097/GOX.0000000000006565. eCollection 2025 Mar.
Chest-wall contouring surgery is an important step in the transitional journey of many transgender individuals who choose to undergo masculinization procedures. Traditional gender-affirming chest surgery does not include reinnervation of the nipple-areolar complex (NAC) or the mastectomy skin flaps and risks partial or complete denervation of these areas. Efforts to restore sensation have emerged leading to various sensory nerve transfer techniques including direct neurorrhaphy to the repositioned NAC or to underlying dermatosensory elements. Here, we describe a novel technique in which we perform a nerve transfer from the anterior lateral branch of the fourth intercostal nerve (of the breast parenchyma to be resected) to the anterior lateral branch of the third or second intercostal nerve in the mastectomy skin flap. There has been no increased risk of complications, and results so far are promising. As we continue to collect long-term outcome data, the effectiveness of NAC reinnervation using this technique will be presented in a forthcoming publication.
胸壁塑形手术是许多选择接受男性化手术的跨性别者过渡过程中的重要一步。传统的性别确认胸部手术不包括乳头乳晕复合体（NAC）或乳房切除皮瓣的神经再支配，并且存在这些区域部分或完全去神经支配的风险。恢复感觉的努力已经出现，导致了各种感觉神经转移技术，包括直接神经缝合到重新定位的NAC或其下方的皮肤感觉元件。在此，我们描述了一种新技术，即我们将第四肋间神经（待切除的乳腺实质）的前外侧分支转移至乳房切除皮瓣中第三或第二肋间神经的前外侧分支。并发症风险没有增加，迄今为止的结果很有前景。随着我们继续收集长期结果数据，使用该技术进行NAC神经再支配的有效性将在即将发表的出版物中呈现。
