A great question!
In general, I want to preserve the blood supply and nerve supply to the nipple. The milk duct system follows the blood and nerve supply, so as long as the blood supply and nerve supply are fine, you should be able to have normal sensation long-term, and also have the ability to lactate or produce milk long-term as well.
In breast augmentation surgery, any surgical incision to place the implants should result in normal nipple sensation and normal ability to produce milk. This is also true for any breast lift and breast reduction procedure.
Generally, I strive not to cut off the entire nipple areolar complex, and re-sew it back on as a free tissue graft. It may look OK, but it will probably not function OK. The nipple will probably be numb and will not have normal ability to lactate long-term.
When the sensation to the nipples comes back, you usually feel unusual feelings shooting towards your nipple, such as
– shooting pains
– electrical shocks
Just be happy! This means that your nerves to the nipple are actually growing back. These sensations are random, and can occur at any time of the day or night. They will also occur in any body position.
In rare cases, the nipple areolar complex may need to be removed and re-sewn in. This usually occurs in patients with poor blood flow or a large amount of breast tissue tightening, such as in smokers, diabetics with poor control of their blood sugar levels, or patients with very large breast reductions.
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