Am I a Candidate for Breast Neurotization with ReSensation™?

Contributors
ReSensation Editors
Constance Chen, MD

ReSensation Surgeon

28 Dec 2018

After a mastectomy, it’s common for women to experience a loss of sensation in the chest area. The reason for the loss of feeling is that during the mastectomy, surgeons cut the sensory nerves when they remove the breast tissue.

For many women, the changes in sensation are permanent, persisting even after reconstruction. While breast reconstruction can restore the shape, size, symmetry and softness of breasts – known as the four “S’s” – reconstruction doesn’t typically focus on the fifth “S,” sensation.

ReSensation™ is a new technique developed to address the fifth “S.” Using allograft nerve tissue, plastic surgeons who perform ReSensation reconnect nerves severed during mastectomy. The ReSensation technique is performed during autologous breast reconstruction, also known as flap reconstruction. Flap reconstruction uses a woman’s own tissue to form a breast shape.

When women hear about ReSensation, one of their first questions is often: Am I a candidate for the procedure? Here are a few things you need to know about who may be a candidate for ReSensation.

While breast reconstruction can restore the shape, size, symmetry and softness of breasts – known as the four “S’s” – reconstruction doesn’t typically focus on the fifth “S,” sensation.

ReSensation Editors

ReSensation is typically performed with “free” flap reconstruction, in which the tissue is fully detached from elsewhere in the body and repositioned on the chest.

ReSensation Editors

Women who have delayed reconstruction may be candidates for ReSensation, as long as the type of reconstruction they choose is flap reconstruction using natural tissue.

ReSensation Editors

ReSensation is performed during autologous flap breast reconstructions, so a primary consideration for surgeons is whether a woman is a good candidate for flap reconstruction.

ReSensation Editors

Q. I’m considering breast reconstruction and am interested in ReSensation. Does it matter what kind of breast reconstruction I get?

Yes. ReSensation is available only with free flap, also known as autologous, breast reconstruction. Flap reconstruction uses tissue, often taken from the abdomen, buttocks, inner thighs or back, to recreate a natural-looking breast. Using magnification during surgery, plastic surgeons reattach blood vessels in the flap to those in the chest.

When ReSensation is included as part of the flap reconstructive surgery, the surgeon attaches nerves in the chest with nerves in the flap using a nerve allograft. The allograft nerve is used to bridge the nerve gap between the nerve ends of the flap tissue with those found in the chest, allowing the opportunity for the nerve fibers to regrow and potentially provide sensation in the breast.

Q. Can plastic surgeons perform ReSensation with any type of flap reconstruction?

ReSensation is typically performed with “free” flap reconstruction, in which the tissue is fully detached from elsewhere in the body and repositioned on the chest.

The most common type of free flap reconstruction is the DIEP (deep inferior epigastric perforator) flap, in which fat, skin and blood vessels are moved from the lower abdomen to the chest to recreate a breast form. ReSensation can also be performed with other types of free flap reconstruction, including the SIEA, TRAM and PAP flaps.

Q. I had a double mastectomy. Can ReSensation be done in both breasts?

Yes. Women who have had a bilateral mastectomy (both breasts removed) or a unilateral mastectomy (one breast removed) may be eligible for ReSensation.

Q. I had a mastectomy a while ago and decided to wait to have breast reconstruction. Is ReSensation available to women who have opted for a delayed reconstruction?

Yes. Women who have delayed reconstruction may be candidates for ReSensation, as long as the type of reconstruction they choose is flap reconstruction using natural tissue.

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Q. I’ve already had breast reconstruction. Can I still get ReSensation?

ReSensation is performed at the same time as autologous breast reconstruction; it can’t be done after the fact. However, some women who have implant-based reconstruction eventually decide they no longer want implants, or they experience complications with the implants and decide to have the implants removed.

Instead of getting new implants or forgoing reconstruction altogether, some woman may opt for secondary autologous, or flap, reconstruction, using their own tissue. Women undergoing secondary flap reconstruction after implant removal may be candidates for ReSensation.

Q. What other considerations factor in when determining whether a woman is a candidate for ReSensation?

ReSensation is performed during autologous flap breast reconstructions, so a primary consideration for surgeons is whether a woman is a good candidate for flap reconstruction. Breast and plastic surgeons will consider numerous factors when making recommendations on flap reconstruction, including a woman’s age, body type, overall health status, previous surgeries, cancer status, and other medical conditions.1

But it’s important for women to keep in mind that not all plastic surgeons offer autologous flap reconstruction, and even fewer incorporate breast nerve repair (also known as breast neurotization).

Some plastic surgeons offer only implant-based reconstruction. Even among surgeons who offer flap reconstruction, not all offer DIEP, SIEA, TRAM or PAP specifically. Even fewer offer ReSensation. If a surgeon doesn’t perform a particular procedure, it’s unlikely a woman will be presented with that option.

To have the opportunity to choose ReSensation, women may need to seek out plastic surgeons who do both autologous flap reconstruction and ReSensation. Our surgeon locator can help you find surgeons who perform autologous flap reconstruction with ReSensation.

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