Sensory nerve repair at time of DIEP flap breast reconstruction may restore feeling after mastectomy

For patients undergoing mastectomy for breast cancer treatment, loosing feeling is a very common concern. During a mastectomy, nerves supplying the breast with feeling are severed causing loss of sensation. Patients undergoing mastectomy must be informed they can potentially lose all feeling to the chest area, regardless of whether they choose to have breast reconstruction or not. In fact, any breast surgery can lead to some degree of sensation changes.

Patients undergoing mastectomy can regain some sensation over time, but it is usually minimal, if any. However, thanks to advances in surgical techniques, patients choosing to reconstruct their breasts using their own tissue have a higher chance of experiencing return of feeling to the breast over time.

During some types of autologous ("flap") breast reconstruction, an extra procedure known as microneurorrhaphy can be performed. Microneurorrhaphy is the joining together of two nerves using microsurgery. During DIEP flap and SIEA flap surgery for example, a sensory nerve that provides feeling to the lower abdominal skin can be included and transferred with the flap. When the flap is connected to the chest to reconstruct the new breast, this nerve is rejoined to nerves cut during the mastectomy. This extra step provides patients with a higher likelihood of regaining sensation to the new breast, in a shorter amount of time. Microneurorrhaphy can be performed in conjunction with some other types of flap reconstruction too.

"The field of nerve regeneration research has made significant progress over the last decade providing the reconstructive surgeon with improved knowledge of how to reconstruct a body part to not only look like its natural counterpart, but to also function and feel natural to the patient. Although much work remains to be done in this area, restoring feeling to the reconstructed breast is showing some promising results," says Dr. Oscar Ochoa.

Two-time breast cancer survivor Terri Coutee underwent bilateral mastectomy with radiation. She then traveled from Arizona to PRMA in San Antonio, Texas for breast reconstruction. "I am one of these women who has regained sensation and I know others who have had the same fortunate experience," Terri shares. "My surgeon successfully reattached sensory nerves and I have sensation in my right breast after bilateral DIEP flap breast reconstruction. The feeling is below my nipple in a wide area under my breast. It is certainly not the original feeling before mastectomy, but one I so appreciate having! It is worth asking the question during your initial consult to see if sensory nerve reconstruction can be done."