Defining Predictors of Tactile and Thermal Sensory Recovery After Reduction Mammaplasty: Insights from Multimodal Testing.

[BACKGROUND] Sensory loss following reduction mammaplasty remains a key concern for patients. While general tactile recovery has been well studied, less is known about temperature sensation or region-specific recovery patterns. This study evaluates tactile and thermal sensory recovery across the breast and identifies clinical and operative predictors of postoperative sensory loss.

[METHODS] A prospective cohort study was conducted at our institution and enrolled patients undergoing bilateral reduction mammaplasty using a superior or superomedial pedicle and Wise-pattern incisions. Tactile sensation was measured using a pressure-specified device, and thermal sensation was assessed via heat and cold detection. Testing was performed preoperatively, and at 1 month and 3-6 months postoperatively. Linear and logistic regression analyses were used to identify predictors of sensory loss, including age, BMI, and resection weight.

[RESULTS] Forty-nine patients (98 breasts) were included. Tactile sensation worsened significantly at the NAC and inner breast at 1 month but returned to baseline by 3-6 months. Thermal sensation at the NAC and inferior breast remained impaired at 3-6 months. Resection weight predicted early tactile loss, while BMI and age were associated with early thermal deficits. At 3-6 months, higher BMI-but not resection weight-remained a predictor of persistent tactile loss. No long-term predictors of thermal sensation were identified.

[CONCLUSION] Tactile and thermal recovery follow distinct patterns after breast reduction. Resection weight affects short-term tactile outcomes, while higher BMI predicts long-term tactile impairment. These findings support personalized patient counseling to guide postoperative patient expectations.