Work

Intercostal Nerve Transfer as a Novel Technique for Sensation Preservation in Gender-affirming Subcutaneous Mastectomy

Year: 2025

Type: article

Abstract: Chest-wall contouring surgery is an important step in the transitional journey of many transgender individuals who choose to undergo masculinization procedures. Traditional gender-affirming chest surgery does not include reinnervation of the nipple-areolar complex (NAC) or the mastectomy skin flaps and risks partial or complete denervation of these areas. Efforts to restore sensation have emerged leading to various sensory nerve transfer techniques including direct neurorrhaphy to the repositioned NAC or to underlying dermatosensory elements. Here, we describe a novel technique in which we perform a nerve transfer from the anterior lateral branch of the fourth intercostal nerve (of the breast parenchyma to be resected) to the anterior lateral branch of the third or second intercostal nerve in the mastectomy skin flap. There has been no increased risk of complications, and results so far are promising. As we continue to collect long-term outcome data, the effectiveness of NAC reinnervation using this technique will be presented in a forthcoming publication.

Source: Plastic & Reconstructive Surgery Global Open

DOI: 10.1097/gox.0000000000006565

Authors: Walter Lin, Ashley Titan, Veronique Doucet, Brian Pridgen, Bauback Safa

Institutions: Stanford Medicine, Stanford University

Language: English

Topic: Breast Implant and Reconstruction

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,195