Breast
reconstruction surgeons describe two kinds of breast sensation –
“touch” and “deep touch.” “Touch” refers to the sensation
on the surface of your skin. “Deep touch” is the pressure you
feel against your chest wall when you're hugged. Skin-sparing
procedures may help preserve some of the touch sensation, whether you
choose an implant or a flap procedure. Flaps do offer the possibility
of nerve regeneration within the flaps, however. And since fat is
softer and may transmit pressure easier, some reconstructive surgeons
think reconstruction using your own fat might increase the sensation
of deep touch. But you should experience deep touch with implants, as
well.
No
matter what reconstruction procedure you choose, you'll probably
experience significant numbness of your breasts. The good news is
that your numbness will likely lessen over time, even years after
surgery. For some women, though, the numbness never improves to any
significant degree. Nerve regeneration in your breasts occurs at the
outside edges first, moving inward toward the nipple area. Your
nipples themselves will never regain the erotic sensation they had
before, though, even with a nipple-sparing mastectomy.
If
you choose flap reconstruction, there will be numbness at your donor
site as well. The pattern of nerve regeneration is similar to your
breasts. Again, feeling returns farther out from the site first,
gradually returning to the area closest to the incision last.
Some
surgeons are attempting to reattach severed nerves during
reconstruction. At present, the results are not yet proven, though
various claims are made. The network of nerves in the breast looks
like a river with many branches heading in a myriad of directions.
Which nerve ultimately connects to which area of the breast is
extremely complicated and almost impossible to ascertain. Since many
women experience spontaneous nerve regeneration as part of their
body's own healing process, it's difficult to determine if the return
of sensation was due to the surgeon's intervention or would have
happened on its own.
As
your body heals following reconstruction, you may begin noticing
strange zings, itches, and prickly feelings in your breasts and donor
sites. These are good signs. They show that the nerves in those areas
are functioning and are likely regenerating. Celebrate!
P.S.
My own spin on breast sensation: Most of the time I'm doing anything,
I'm wearing a bra. Most of the time when I'm hugging people, I'm
wearing a bra. Bras mute skin sensation. And since I never noticed a
lessening in “deep touch” sensation, hugs after two breast
reconstructions feel the same as before.
Lessened
breast skin sensation is only an issue for me when I'm sans
bra. Well, I guess that's the same for everyone... Hugging, without a
bra, still feels great. I don't feel a loss. It involves so much more
of me than the skin feeling on the very front of my breasts. It
involves “deep touch” and let me add “emotional touch.”
I
discovered a strange phenomenon, though, while working on this blog
post. I'm not sure what to make of it. I could have sworn almost all
my skin sensation had returned. I decided to perform an experiment,
to be sure. I closed my eyes and lightly ran a bobby pin over my
breasts. I found there was more numbness than I experience in my
day-to-day (and night-to-night) life. I've apparently overestimated
the actual return of sensation to my own breasts! How is this
possible? I have a theory.
I
believe our memory can fill in lost details regarding
sensation – or lack of it. I'd noticed this about my nipples—my
recollection of the feeling is so close, so vivid, that it's almost
there in my skin. I call on it when I need to... We've all
experienced this with visual or auditory memory, but I think it's
also true of “touch memory.” Add the touch memory to the visual
reality of your partner enjoying your new breasts, and you may also
perceive...imagined? phantom? self-hypnotic?...return of sensation. I'm not going to do a Google search on this one. I've
experienced it myself.
