Innervation of the Nipple Areolar Complex (NAC):

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The innervation of the nipple areolar complex (NAC):
    • Is from the anterior and lateral branches of the 3rd, 4th, and 5th intercostal nerves:
      • Of which the lateral cutaneous branch of the 4th intercostal is dominant
  • This nerve has the greatest risk of injury during a resection of the central lower pole of the breast:
    • A superior pedicle, with resection of the lower pole:
      • Has the highest incidence of NAC sensory compromise
    • All patients should be advised that there is a risk of permanent loss of sensation
  • References
    • Riccio CA, Zeiderman MR, Chowdhry S, Brooks RM, Kelishadi SS, Tutela JP, et al. Plastic surgery of the breast: keeping the nipple sensitive. Eplasty. 2015;15:e28.
    • Chiummariello S, Angelisanti M, Arleo S, Alfano C. Evaluation of the sensitivity after reduction mammoplasty. Our experience and review of the literature. Ann Ital Chir.2013;84(4):385-388.
    • Schlenz I1, Rigel S, Schemper M, Kuzbari R. Alteration of nipple and areola sensitivity by reduction mammaplasty: a prospective comparison of five techniques. Plast Reconstr Surg. 2005;115(3):743-751.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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