Study of cutaneous sensitivity of the nipple-areolar complex using Semmes—Weinstein monofilaments in patients after breast reduction surgery

Objective. To evaluate and compare the frequency of tactile sensitivity disruptions in NAC among patients after reduction mammoplasty based on the type of pedicle used. Material and methods. The study included 100 patients (average age 46.4 years, average BMI 26.4 kg/m²) who underwent reduction mammoplasty from 2023 to 2026. A lateral pedicle was used in 40% of the cases, a medial pedicle in 30%, and upper and lower pedicles in 15% each. Tactile sensitivity was assessed postoperatively at six months using Semmes—Weinstein monofilaments. The evaluation was conducted at five control points on the NAC. A loss of sensitivity was defined as the absence of pressure sensation during three consecutive tests at least at one point. Results. The lowest frequency of sensitivity loss was found in the group with the lateral vascular pedicle at 7.5%. In the medial pedicle group the rate was 76.7%, the upper and lower groups showing 46.7% and 33.3%, respectively. Statistical analysis confirmed a significantly lower risk of sensitivity loss with the lateral pedicle compared to the medial (p<0.001), upper (p<0.05), and lower (p<0.05) pedicles. Discussion. These findings align with anatomical studies, which indicate that the primary source of innervation of the NAC (in 93% of cases) is the lateral cutaneous branch of the fourth intercostal nerve. The use of a lateral pedicle minimizes damage to these nerves. Additionally, existing literature highlights variability in the recovery times of sensitivity and the dependency of outcomes on the selected surgical technique. Conclusion. Lateral dermoglandular pedicle demonstrates significantly better results in maintaining tactile sensitivity of the NAC during the postoperative period compared other pedicles. The choice of the type of vascular pedicle should be made individually, taking into account the anatomical characteristics.