Sensory recovery of the breast after innervated and non-innervated autologous breast reconstructions: A systematic review

Summary Background The sensory recovery of the reconstructed breast is an undervalued topic in the field of autologous breast reconstruction. The aim of this systematic review was to evaluate the available literature on the sensory recovery of the breast after innervated and non-innervated autologous breast reconstructions and to assess the possible benefits of sensory nerve coaptation compared to spontaneous reinnervation of the flap. Methods A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane Library to identify all eligible studies regarding the sensory recovery of all types of innervated and non-innervated autologous breast reconstructions. Results The search yielded 334 hits, of which 32 studies concerning 1,177 breast reconstructions were included. The amount of heterogeneity between studies was high and made pooling of data difficult. The studies indicated that spontaneous reinnervation of autologous breast reconstructions occurred to a variable extent, depending on how and when it was measured. Despite these variable results, the sensory recovery of innervated flaps however, was superior, started earlier and gradually improved over time with a higher chance of approaching normal values compared to non-innervated flaps. There was a lack of studies that assessed the return of erogenous sensation and quality of life. Conclusion The current evidence showed that nerve coaptation resulted in superior sensory recovery of the reconstructed breast compared to spontaneous reinnervation of the flap. This review illustrated that more standardized, high-quality studies with adequate sample sizes are needed to objectively evaluate the sensory recovery of the breast after autologous breast reconstructions.