How to Preserve the Nipple Erogenous Sensation in Breast Lifting and Reduction Mammaplasties

Preservation of nipple sensitivity after breast reduction is an important goal to achieve. However, most breast reduction techniques focus more on breast aesthetics and nipple areolar complex vascularity, ignoring nipple sensitivity particularly nipple erogenous sensation. In fact, the nipple nervous system includes a tactile sensation system and an erogenous sensation system, the latter being less described and commonly overlooked by plastic surgeons performing breast reductions. The erogenous sensation is supplied by the IVth, Vth and VIth intercostal nerves who run laterally on the surface along the muscular aponeurosis. The total posterior pedicle breast reduction technique described by Richard Moufarrege in 1982 consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its robust blood supply to the nipple areolar complex, for its preservation of the breastfeeding function and for its low rate of long term complications such as pseudoptosis. In this article, we also demonstrate that the Moufarrege Total Posterior Pedicle preserves the nipple erogenous sensation among women undergoing breast reduction using this technique.