Nerve-Preserving Mastectomy And Resensation

As a microsurgeon, Dr. Dhivya R. Srinivasa, MD, FACS is proud to offer advanced microsurgical techniques to not only offer all-natural and implant-free breast reconstruction, but also nerve surgery to optimize breast and nipple sensation after a mastectomy

Why choose Dr. Srinivasa?

Dr. Dhivya Srinivasa is a double board-certified plastic surgeon with elite Fellowship training in microsurgery. She is committed to helping women navigate their healing journey after breast cancer so they can reclaim their confidence and peace of mind. Dr. Srinivasa is passionate about employing the latest cutting-edge techniques to help patients enjoy a feminine, attractive figure after breast reconstruction and a sense of normalcy in their bodies. She is a compassionate and empathetic listener who tailors each unique treatment plan to the individual’s wishes and goals. As a surgeon who favors a holistic approach to care, Dr. Srinivasa has designed a practice that hinges on the most advanced techniques available for breast reconstruction. Her extensive training in microsurgery has positioned her to offer the best that the field has to offer with mastectomy reconstruction: all natural or direct to implant reconstruction coupled with nerve preservation and reconstructive techniques to optimize sensation.

What is nerve-preserving mastectomy?

Sensation-preserving mastectomies are recommended for those at high risk of a future breast cancer diagnosis and those currently diagnosed with breast cancer. The procedure involves preserving and/or reconstructing the nerves that run through the breasts so that patients will be able to enjoy sensation in the skin and nipples after surgery. Mastectomies are an excellent method of eradicating cancer; however, they often obliterate the delicate nerves during the operation, leading to numbness or in the worst cases, discomfort and nerve pain. Sensation-preserving mastectomy can help safely preserve nerves, reconstruct those that need to be severed, and restore sensation to the breast, areola and nipple.

What are the benefits of nerve-preserving mastectomy and resensation?

A more positive self-image

Even with the breasts reconstructed, patients may still experience the chest as “foreign” since they have lost sensation in the area. Nerve preservation and re-sensation allow women to enjoy a more positive body image that is feminine and natural.

Enhanced quality of life

Women who have retained sensation in the breasts and nipples can enjoy improved intimacy with partners instead of feeling like a key aspect of their lives has been stolen. Resensation can help provide a sense of normalcy in relationships.

Emotional well-being

Women who have experienced breast cancer and mastectomy have no doubt been significantly affected by their experience. Being able to retain sensitivity in the breasts and nipples can help them to overcome emotional pain and start down the path to healing – emotionally, physically, and spiritually.

Who is a candidate for nerve-preserving mastectomy?

As each patient will have different reconstruction needs, it is critical to undergo a private consultation with Dr. Srinivasa in order to determine your candidacy for sensation-preserving procedures. The cancer’s size and location as well as patient expectations may determine what is possible in each individual case.

In general, ideal candidates…

Are at high risk of breast cancer
Have genetic markers related to breast cancer
Have been diagnosed with breast cancer
Are medically stable enough to undergo surgery
Have a strong immune system to fight off infection and illness
Desire to retain sensation in the breasts and nipples

What makes sensation preserving mastectomies unique?

A mastectomy can be a life-altering procedure that promotes longevity and elevates quality of life. However, many women are unaware that they may no longer experience skin or nipple sensation after their surgery. Traditional mastectomies typically slice through the delicate nerves traveling through the breast tissue, resulting in numbness, and in the worst-case scenario, pain for the patient. While some women may get lucky and find that sensation returns over time, most are stuck with a loss of feeling or pleasure in the breasts, which can act as a daily reminder of their cancer ordeal.

Sensation preserving mastectomy helps women feel more at home in their bodies and allows them to enjoy the self-confidence they used to have before their illness. Dr. Dhivya Srinivasa’s elite microsurgery training and adoption of cutting-edge surgical techniques such as nerve grafting enable her to perform the most challenging reconstructive surgeries while carefully preserving breast and nipple sensation for her patients.

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How is the nipple preserved?

Mastectomies are recommended for patients with breast cancer as well as for those at high risk of developing breast cancer in the future. Today’s mastectomy techniques are far less invasive than in the past when surgeons used to remove the majority of the skin from the chest as well as muscle. Today, a mastectomy can be performed in combination with expert reconstruction to preserve both the skin and the nipple-areolar complex. This helps to create breasts that both feel and look extremely natural.

Where are the incisions?

Sensation preserving mastectomy is performed using four common incision types, each of which allows for optimal scar healing over time.

Inframammary incision

Here, the incision is made along the breast crease at the base of the breast mound, where scarring will later be well-concealed by the bra line.

Periareolar incision

A periareolar incision encircles a portion of the outer edge of the areola. Scarring is later well-hidden within the darker skin pigments of the area.

Lateral incision

A lateral incision stretches from the side of the areola outward horizontally to the side of the breast.

Inferior vertical incision

With this approach, the incision stretches from the bottom of the areola vertically down to the breast crease.

Many factors influence the ideal placement of the incisions, including the patient’s preferences when it comes to scarring. Dr. Srinivasa will choose the best option for each individual based on their needs, wishes, and goals.

What is nerve grafting?

In order to preserve the nerves in the breasts, the surgeon must have an in-depth understanding of nerve anatomy and location. It is important to grasp where the nerves originate from and how they branch out in the chest. Nerve grafting can be performed with immediate breast reconstruction to reconnect severed nerves. An allograft tissue scaffolding can be employed to act as a guide for the nerves so they can regenerate over time without causing tension or discomfort.

What is flap neurotization?

Flap neurotization is a microsurgical technique performed to improve outcomes after breast reconstruction. The autologous flaps Dr. Srinivasa uses contain sensory nerves. She can harvest these nerves along with the donor tissue and connect them to nerves in the chest. This process allows the tissue itself to have feeling so that reconstruction isn’t experienced as foreign or unnatural.

What results should I expect?

Dr. Dhivya Srinivasa’s experience has been that the majoriaty of patients undergoing sensation preserving mastectomies with reconstruction retain sensation that is similar to what they enjoyed before their illness. In fact, many patients report that their breasts feel so normal that they sometimes forget they had a mastectomy at all.

Dr. Srivinvasa in scrubs looking at camera.

Schedule your private consultation with Dr. Srinivasa in Santa Monica, CA, today

If you are interested in learning more about nerve-preserving mastectomy, nipple resensation, flap neurotization, or nerve grafting, contact our office today to set up your detailed consultation with Dr. Srinivasa. During this first meeting, the doctor will discuss your goals, wishes, and preferences in order to gain a clear understanding of what you want to accomplish with your procedure. She will then conduct a thorough physical evaluation and review of your medical and surgical history. At that point, Dr. Srinivasa can begin to curate your customized treatment plan for success. It all starts with a simple phone call to her office in Santa Monica, CA.