A. R. del Río-Hernández1,2, R. Esquiliano-Raya2, X. González-López2, C. Domínguez-Suárez2, J. R. Gomez-Woodworth2, J. E. Telich Tarriba3,4
1 Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA2 Faculty of Health Sciences, Universidad Panamericana, Mexico City, Mexico 3 Hospital Angeles Pedregal, Mexico City, Mexico4 Peripheral Nerve Surgery Clinic, Hospital General “Dr. Manuel Gea Gonzalez”, Mexico City, Mexico
Summary
Breast reconstruction has advanced significantly, yet loss of nipple–areola complex (NAC) sensation after mastectomy remains a key limitation, particularly in implant-based breast reconstruction (IBR). This systematic review evaluates the effectiveness of nipple neurotization in restoring sensation following IBR. Eight studies including 131 patients (181 breasts) were analyzed. Techniques primarily involved intercostal nerve coaptation using allografts, autografts, or direct repair, most commonly the fourth intercostal nerve. Sensory recovery was consistently reported, with improvement detectable as early as 3 months and progressive gains over time. Neurotized breasts demonstrated superior outcomes in objective sensory testing and patient-reported measures, including psychosocial and sexual well-being. Despite heterogeneity and small sample sizes, findings suggest nipple neurotization is a safe and promising adjunct to IBR, warranting further standardized studies.
Key words
breast neoplasms – breast implantation – nerve transfer – mastectomy – sensation – allograft – autograft – nipples
Del Río-Hernández AR, Esquiliano-Raya R, González-López X et al. A systematic review of sensory outcomes in nipple reinnervation after implant-based breast reconstruction. Acta Chir Plast 2026; 68 (1–2): 19–25.