Temporal Patterns of Tactile and Thermal Recovery After Dual-Nerve Coaptation in Autologous Breast Reconstruction

Dual neurotization in DIEP flap breast reconstruction was evaluated using objective tactile (PSSD) and thermal discrimination testing at serial postoperative timepoints. Tactile sensation recovered to approximately 47% of baseline at 3 months, 59% at 6 months, 58% at 9 months, and 66% at 12 months. Thermal discrimination improved progressively, with cold detection reaching 35%, 42%, 44%, and 58% of baseline and heat detection reaching 54%, 65%, 68%, and 76% at corresponding timepoints. Regional analysis demonstrated earlier recovery in superior and medial territories, while the nipple–areolar complex consistently showed the lowest recovery. By 12 months, select regions were statistically indistinguishable from baseline (white dots), indicating near-complete recovery in those areas. These findings demonstrate modality-specific recovery trajectories, with tactile sensation improving earlier and thermal discrimination demonstrating a more gradual course.