Assessment and reporting of nipple-areola complex sensation after reduction mammaplasty: A scoping review.

Abstract

Reduction mammaplasty is the mainstay treatment for breast hypertrophy and gigantomastia. Although surgical techniques aim to preserve nipple-areola complex sensation, sensory alterations remain a common complication with implications for sexual function, breastfeeding, and quality of life. Despite its frequent reporting, heterogeneity exists in how nipple-areola complex sensation is assessed and reported, thereby limiting comparability and interpretation of functional outcomes. This scoping review aimed to map and characterize current methods used to evaluate and report nipple-areola complex sensory outcomes following reduction mammaplasty. A scoping review was conducted following the Arksey and O'Malley framework and reported according to PRISMA-ScR guidelines. The MEDLINE, Web of Science, and CENTRAL databases were searched for studies published in the last 10 years in English or Spanish. Eligible studies included randomized trials, observational studies, and case series involving adult female patients undergoing reduction mammaplasty with explicit evaluation of nipple-areola complex sensation and description of the assessment method used. Data were synthesized descriptively. Twenty-nine unique studies were included. Methodological heterogeneity was identified across sensation assessment methods, measurement scales, anatomical testing sites, timing of evaluation, follow-up duration, and outcome definitions. Objective testing, preoperative baseline evaluations, and validated assessment tools were inconsistently applied. Sensory outcomes were not contextualized within clinically relevant domains (quality of life, sexual function, or breastfeeding). A standardized framework incorporating validated objective tools, baseline evaluation, and patient-reported outcome measures is proposed. Greater methodological standardization and integration of patient-reported outcome measures may be warranted to improve the clinical interpretability and comparability of sensory outcomes.