TECHNIQUES FOR PRESERVING AND RESTORING SENSATION FOLLOWING MASTECTOMY AND AUTOLOGOUS BREAST RECONSTRUCTION

Preserving and restoring sensation at the time of or following mastectomy is the next frontier in breast reconstruction. Knowledge of intercostal nerve anatomy in the breast can allow for preservation of nerve branches at the time of mastectomy when oncologically safe, as well as identification of nerve targets to use for nerve reconstruction and nipple-areolar complex neurotization. For autologous recon-struction, neurotization can be done in the immediate setting at the time of mastectomy as well as in the delayed setting with use of either nerve autograft harvested with the flap or cadaveric nerve allograft when required. With proper patient expectation setting and incorporation of post-operative sensory rehabilitation protocols, successful return of breast sensation following mastectomy and autologous reconstruction can be achieved for many patients.