Concerning nipple sensitivity post op

[rekhter]

I have a mild case of gynecomastia and I am planning on having surgery.  However, after reading the comments on this forum, I am afraid that I will lose my nipple sensitivity.  I am concerned because this is an important part of my erotic life.  My doctor said that if he does not remove the gland sensitivity will more or less stay the same.  Is that true?

Thank you.

[Litlriki]

Erotic sensibility of the nipple is mediated by a deep branch of the nerve that comes out from under the 4th rib.  When we do gland resection, it is guaranteed that this nerve will be cut--there's not really any way to do the procedure without doing it.  This issue was first brought to my attention many years ago by a patient who explained that he had such sensitivity pre-op, but after the surgery, although he was able to feel his nipples, he no longer had erotic sensibility.  I discuss this with all of my patients, and it's rare that any of them opt for liposuction only, but it does happen on occasion.  Most recently, the patient involved didn't really require gland excision, so he should have a good aesthetic outcome while hopefully preserving the erotic sensation.  If, on the other hand, you have significant glandular tissue, you may find that liposuction alone will not provide complete resolution of your gynecomastia.  You and your surgeon should discuss this pre-operatively, so that you can decide if it's more important to have complete removal of the gynecomastia, or if you'd rather use an approach that might protect that sensibility.

Good luck,

Rick Silverman

[Dr. Elliot Jacobs]

Totally agree with Dr. Silverman.

However, erotic sensitivity of the nipple is as much in the mind as it is anatomic.  Consider that breast reduction in women involves a multitude of possible techniques, many of which interrupt many of the nerves to the nipples.  But remember that there are hundreds of tiny end-branches of the nerve -- and some of them do survive -- and seem to "take-over" the job of providing sensation.  Most women who have breast reduction retain a great deal of their erotic sensitivity.

Dr Jacobs

[DrPensler]

The fourth intercostal nerve is an important component in nipple sensitivity. The nerve is sectioned with gland excision so there is some diminution of nipple sensation.If the loss of any sensation overrides any potential aesthetic benefits you should not have surgery.