Plastic Surgeon Questions Breast Augmentation

Can plastic surgery put one at a risk of nerve damage?

I am planning to undergo breast augmentation surgery. However, as I was going though the list of documents about the surgery I read that there is a risk of nerve damage. What puts one at a risk of a nerve damage during the surgery?

15 Answers

Too large an implant and its necessary pocket creation, the higher the risk of reducing nipple sensation by damaging the sensory nerve along the rib cage and side of the breast. Rely on the experience and board qualification of your plastic surgeon!
The two more common risks include: Very quick surgery without regard to the anatomy (specifically the nerves) and implants that are too big that put extra stretch on the nerve. Nobody likes numb nipples. Typically it takes me 3 hours to do a breast augmentation for this very reason.
Thank you for your question. In your question, you ask about the possibility of breast augmentation surgery leading to nerve damage. I can definitely help guide you as you decide. The risk for nerve damage is always a possibility in most surgeries, but it is not a particularly high risk in breast augmentation surgery. It is higher in breast reduction. Current literature suggests the risk is at 0.5%. I would strongly advise you to seek out a board-certified plastic surgeon with a lot of experience performing breast augmentation surgery. In general, when nerve damage occurs it is temporary and rarely it is permnant.
Nerve damage is a potential risk of almost any operation as our nerves run throughout all parts of our bodies. During breast augmentation nerves can be injured, although this rarely happens. Sensory nerves including those which supply feeling to the nipples, can be injured during a long breast augmentation. Please speak directly to your surgeon about this potential risk.
Breast augmentation has come a long way, and with the newer implants and newer access techniques, the surgery is quite safe. A well-educated and trained surgeon is a must!
The nerves that supply sensation to part of the breast or nipple can either be significantly stretched as the tissues are expanded or even nicked or cut in the dissection process. Fortunately, this very rarely occurs.

Verne Weisberg, MD, FACS
Thank you for the question. In breast augmentation, there is need to create a pocket to receive the implant. This pocket may be retroglandular, behind the breast gland, or under the muscle, retromuscular. In any case, there is extensive dissection. This may cause some numbness in the breast. In general, this is transient and recovers well. The advice is to discuss this particular topic with your surgeon, prior to surgery.

Luis A. Laurentin-Perez, MD PhD
Any time you have surgery on your breast, post-op, there may be less sensation in your breast and nipple. It is not a complication, it is just a normal post-op event. Sometimes the post-op sensation is the same as before and sometimes it is less. Nothing bad was done, just stretching the skin and tissues can give you less sensation. There is no way to guarantee there will not be a change.

William B. Rosenblatt, M.D.
Previous surgery or radiation increases the risk of nerve damage. This is an unlikely complication.

Bahman Guyuron, M.D. F.A.C.S.
You need to discuss this with your surgeon. Yes, there is a risk of nerve damage anywhere from 3%-8% depending on the size of the implant.

William A. Stefani, MD
It depends on what nerve you are referring to. Generally the smaller the implant the less risk. Most nerve injuries are sensory and can produce numbness of the nipple. Dr. Yuan
There is always a small risk of symptomatic nerve damage when undergoing surgery, but what is being referred to by your doctor as regards breast augmentation is a little different.
Nerves which control sensibility to the nipple run in grooves under the ribs and send branches up to the skin as they go. These are next to the breast bone in front and at the side of the chest. Breast implants lie between them, but the nerves can be damaged when the surgeon is opening the pocket to house the prosthesis.
Numbness of the nipple is a rare, but definite possibility post-operatively and may be permanent. They may interfere with breastfeeding, sexual gratification, etc., and, small though the risk may be, you should weigh this in your decision to have the surgery.

I hope this helps,

Dr. M
The nerve that gives sensation to the nipple exits from between the 3rd and 4th ribs on the side and travels through the breast towards the nipple. In the course of creating the pocket to place a breast implant it is possible to injure this nerve. It is very small and very rarely visible. If the nerve is injured or worse yet cut, one may have temporary or permanent loss of nipple sensation. We are usually very careful in this area to prevent any nerve injury but because the nerve cannot normally be seen it is at some risk. The published risk for loss of nipple sensation after a breast augmentation is about 10%
Fine nerves may be injured, but feeling should not be changed appreciably. Nipple sensation should not be changed under normal circumstances. Talk to your surgeon about sensation and possible changes prior to undergoing the procedure.
The majority of the time, nerve injury is not an issue. Most of the cases where the nerve is at risk is when the nerve does not exit in the "normal" or expected location. This is known as an anatomic variant and does put the nerve at risk for injury. Anatomic variations occur in 2-3% of cases, but actual nerve injury is less than that.