{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:26:23Z","timestamp":1790742383368,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>To restore sensation after breast reconstruction, a modified surgical approach was employed by identifying the cut fourth intercostal lateral cutaneous branch, elongating it with intercostal nerve grafts, and coapting it to the innervating nerve of the flap or by using direct neurotization of the spared nipple\/skin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective case\u2013control study including 56 patients who underwent breast neurotization surgery. Breast operations included immediate reconstruction after nipple-sparing mastectomy (36 patients), skin-sparing mastectomy (8 patients), and delayed reconstruction with nipple preservation (7 patients) or without nipple preservation (5 patients). Patients who underwent breast reconstruction without neurotization were included as the non-neurotization negative control group. The contralateral normal breasts were included as positive controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean(s.d.) monofilament test values were 0.07(0.10) g for the positive control breasts and 179.13(143.31) g for the breasts operated on in the non-neurotization group. Breasts that underwent neurotization had significantly better sensation after surgery, with a mean(s.d.) value of 35.61(92.63) g (P &amp;lt; 0.001). The mean(s.d.) sensory return after neurotization was gradual; 138.17(143.65) g in the first 6 months, 59.55(116.46) g at 7\u201312 months, 14.54(62.27) g at 13\u201318 months, and 0.37(0.50) g at 19\u201324 months after surgery. Two patients had accidental rupture of the pleura, which was repaired uneventfully. One patient underwent re-exploration due to a lack of improvement 1.5 years after neurotization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Using the lateral cutaneous branch of the intercostal nerve as the innervating stump and elongating it with intercostal nerve grafts is a suitable technique to restore sensation after mastectomy. This method effectively innervates reconstructed breasts and spares the nipple\/skin with minimal morbidity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znae005","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T06:53:47Z","timestamp":1706770427000},"source":"Crossref","is-referenced-by-count":23,"title":["Elongation of intercostal nerve cutaneous branches for breast and nipple neurotization during breast reconstruction after mastectomy for breast cancer: case\u2013control study"],"prefix":"10.1093","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6878-1574","authenticated-orcid":false,"given":"Tommy Nai-Jen","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"Breast Cancer Centre, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4319-9227","authenticated-orcid":false,"given":"Johnny Chuieng-Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"Breast Cancer Centre, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9609-9583","authenticated-orcid":false,"given":"Cheyenne Wei-Hsuan","family":"Sung","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina M","family":"Illias","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Chang Gung Memorial Hospital , Taoyuan , Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1430-7348","authenticated-orcid":false,"given":"David Chon-Fok","family":"Cheong","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"Breast Cancer Centre, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Wei","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Ling","family":"Kuo","sequence":"additional","affiliation":[{"name":"Breast Cancer Centre, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"},{"name":"Division of Breast Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"School of Medicine, National Tsing Hua University , Hsinchu , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Pindur","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"},{"name":"Department of Plastic, Hand and Reconstructive Microsurgery, BG Trauma Centre Frankfurt am Main, Academic Hospital of the Goethe University Frankfurt am Main , Frankfurt am Main , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6803-7174","authenticated-orcid":false,"given":"Lisa Wen-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer An-Jou","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Chwei-Chin","family":"Chuang","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9568-7834","authenticated-orcid":false,"given":"Jung-Ju","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"Breast Cancer Centre, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"},{"name":"College of Medicine, Chang Gung University , Taoyuan , Taiwan"},{"name":"Centre for Tissue Engineering, Chang Gung Memorial Hospital, Linkou Medical Centre , Taoyuan , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,31]]},"container-title":["British Journal of 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