Comparison study of nipple-areolar sensation after reduction mammaplasty*1

Background: Although many techniques of reduction mammaplasty are currently in use, a prospective study quantitating the sensation of the nipple-areolar complex (NAC) after the performance of specific techniques has not been performed. Objective: The purpose of this study was to quantitate the postoperative sensation of the NAC after reduction mammaplasty and to compare the results on the basis of the orientation of the vascularized pedicle. Methods: We tested 42 patients divided into 4 groups: medial pedicle (9 patients), inferior pedicle (8 patients), free nipple transfer (8 patients), and a control group (17 patients). The specific mammaplasty technique chosen was based on the preoperative assessment and the estimated volume of resection. A Wise pattern approach was used in all cases. NAC sensation was quantified with the use of the Pressure Specified Sensory Device (Sensory Management Services LLC, Baltimore, MD). Results: We detected no significant difference in the volume of reduction between the free nipple group and the medial pedicle group (P =.14). NAC sensation in the free nipple transfer group was significantly lower than either of the pedicle techniques and control group in all areas of testing (P < 0.001), whereas the medial and inferior pedicle groups had no significant sensory differences in NAC sensation (P < 0.001). Conclusions: The medial pedicle technique is safe and reliable and can be used for large-volume reduction mammaplasty to optimize sensation of the NAC.