title: Nerve Injuries in Aesthetic Breast Surgery: Systematic Review and Treatment Options.
abstract: BACKGROUND
  The risk of nerve injuries in aesthetic breast surgery has not been well explored.
  
  
  OBJECTIVE
  The authors conducted a systematic review to provide evidence-based information on the incidence and treatment of nerve injuries resulting from aesthetic breast surgery.
  
  
  METHODS
  A broad literature search of Medline, Embase, and the Cochrane Database of Systematic Reviews was undertaken to identify studies in which nerve injury occurred after breast augmentation or mastopexy. Specific inclusion and exclusion criteria were established before the search was performed.
  
  
  RESULTS
  The initial 4806 citations were narrowed by topic, title, and abstract to 53 articles. After full-text review, 36 studies were included. The risk of any nerve injury after breast augmentation ranged from 13.57% to 15.44%. Specific nerve injury rates were calculated for the intercostal cutaneous nerves, branches to the nipple-areola complex, intercostobrachial nerve, long thoracic nerve, and brachial plexus. Also calculated were the total estimated risks of chronic pain, hyperesthesia, hypoesthesia, and numbness. The meta-analysis showed no associations between the rates of breast nerve injury or sensation change and implant size, incision type, or implant position in patients who underwent breast augmentation. The data were insufficient to determine rates of nerve injury in mastopexy.
  
  
  CONCLUSIONS
  The possibility of nerve injury, sensation change, or chronic pain with breast augmentation is real, and estimating the incidences of these conditions is useful to both patients and surgeons. Optimizing patient outcomes requires timely treatment by a multidisciplinary team and may include peripheral nerve surgery.
  
  
  METHODS
  3.
authors.affiliation: Dr Ducic is a professor and Dr Felder is a resident in the Department of Plastic Surgery, and Ms Fantus is a medical student at Georgetown University Hospital, Washington, DC dr.ducic@gmail.com.
authors.forename: Ivica
authors.initials: I
authors.lastname: Ducic
authors.affiliation: Dr Ducic is a professor and Dr Felder is a resident in the Department of Plastic Surgery, and Ms Fantus is a medical student at Georgetown University Hospital, Washington, DC.
authors.forename: Hesham M
authors.initials: HM
authors.lastname: Zakaria
authors.affiliation: Dr Ducic is a professor and Dr Felder is a resident in the Department of Plastic Surgery, and Ms Fantus is a medical student at Georgetown University Hospital, Washington, DC.
authors.forename: John M
authors.initials: JM
authors.lastname: Felder
authors.affiliation: Dr Ducic is a professor and Dr Felder is a resident in the Department of Plastic Surgery, and Ms Fantus is a medical student at Georgetown University Hospital, Washington, DC.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fantus
mesh_terms: D000328:Adult; D019928:Breast Implantation / Q000009:adverse effects*; D059350:Chronic Pain / Q000209:etiology; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D009460:Neurologic Examination; D010149:Postoperative Pain / Q000209:etiology; D059348:Peripheral Nerve Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012684:Sensory Thresholds; D016896:Treatment Outcome; D055815:Young Adult
keywords: aesthetic surgery; breast augmentation; breast surgery; chronic pain; mastopexy; nerve injury; surgical complications