這個問題恐怕可以問倒很多整形的醫師。如果細問的話,還可以問:乳頭、乳暈和乳房的上下內外側那個部份感覺會改變?會恢復嗎?如果會,那要多久才會恢復?
雖然以前醫師憑著經驗,和問病人所得,有了一個模糊的答案,但並有沒任何數據可以佐證。試想,若是醫師幫病人隆完乳後,去摸病人的乳房,問她感覺如何?恐怕病人不願意做這種「實驗」
美國田納西州的Nashville醫院,使用一種儀器叫the Pressure Specified Sensory Device (Sensory Management Systems, LLC, Baltimore, Md.) 去測量病人隆乳後的乳房、乳暈及乳頭感覺變化,得到了以下結論
Author Okwueze, Martina I. M.D. et al
Institution Nashville, Tenn. From the Department of Plastic Surgery, Vanderbilt University Medical Center.
Title Effect of Augmentation Mammaplasty on Breast Sensation.
Source Plastic & Reconstructive Surgery. 117(1):73-83, January 2006.
Abstract
Background: Studies of alterations in breast sensibility after augmentation mammaplasty have produced conflicting results. Such discrepancies may be attributed to unsophisticated measuring devices used in earlier studies leading to less accurate measurements and to the comparison of results to different surgical techniques. The primary purpose of our study was to conduct a prospective clinical trial to quantify specific sensory outcomes before and after submuscular breast augmentation.
Methods: Preoperative and postoperative questionnaires were used to assess patients’ subjective observations on breast sensation. Quantitative data were collected using a very accurate device, the Pressure-Specified Sensory Device, to assess objective breast sensation. Thirty-three micromastia patients underwent quantitative measurements preoperatively (baseline), at 2 to 4 weeks and 6 months postoperatively to assess breast sensitivity.
Results: The quantitative data showed similar patterns of sensory change between both the periareolar and the inframammary surgical approach over time. The inferior region was the only region that showed a diminished sensitivity threshold of 9.5 +/- 2.9 gm/mm2 for the inframammary incision, a significantly poorer average than the periareolar incision of 1.7 +/- 0.6 gm/mm2 with p = 0.008 at 6 months. Older patients had significantly higher thresholds of sensitivity compared with younger patients (p < 0.02).
Conclusions: Our study suggests that the periareolar incision may produce less sensory loss in the lower pole of the breast when compared with the inframammary incision. The outcome of this study provides both the surgeon and the patient with concrete information regarding mammary sensation after augmentation mammaplasty and leads to a better informed-consent process.
這二張圖是顯示手術後隨著時間,乳房的靜態及動態感覺變化。點愈高,表示感覺愈差。由此我們可以看出二點重要結論:
1. 隨著時間,術後六個月,乳房的感覺漸漸恢復。但是除了乳房外側及乳頭這二處有完全回復(指靜態感覺),其它的部位和術前比較還是比較差。
2.乳房下半部的感覺恢復最差,而且以傷口在乳房下緣的手術方法在這二處的感覺恢復最差。
要注意的是本文只比較乳暈旁和乳房下切口對感覺的影響,並沒有從腋下切口的研究。