Loss of sensation is commonly reported after mastectomy due to transection of intercostal nerves. Sensory loss has been shown to have significant consequences on functional and psychological well-being. Our group has described targeted nipple-areolar complex reinnervation (TNR), which is a technique used to preserve and reconstruct encountered intercostal nerves to maximize sensory recovery during chest surgery

Study Aim: Compare sensory outcomes in patients undergoing targeted NAC reinnervation with DTI breast reconstruction using nerve allografts and GAM utilizing direct coaptation 

Methods:

Prospective cohort study with DTI reconstruction (32 subjects & 24 controls) and GAM (37 subjects & 32 controls). Quantitative Sensory Testing (QST) was performed at baseline and postoperatively (3, 6, and 12 months). Univariate analysis assessed differences between groups at each time point and to their respective controls. 

Results: 

Postoperatively, monofilament testing was significantly better at the chest and NAC in GAM patients at each timepoint (p<0.05). At 12 months, all sensory tests were significantly better at the chest in GAM patients except for pressure, which was similar between groups. Pinprick was significantly better at the NAC in GAM patients, while pressure was similar. At 12 months, all sensory tests had returned to baseline in the GAM group except chest pressure and NAC pinprick. 

Conclusions:

TNR led to improved sensation in both DTI reconstruction and GAM patients. These findings suggest that nerve reinnervation techniques facilitate sensory recovery. While both groups demonstrated significant improvement, GAM patients experienced a more rapid recovery.