A decade after losing sensation in her breasts following a double mastectomy and reconstructive surgery, a doctor suggested a new treatment that finally helped her feel again.
After losing her mother, three maternal aunts, and grandmother to breast cancer, Tara Dalton decided to seek out genetic testing in 2008.
“When it came back BRCA positive, I asked what my options were. I was told double mastectomy seemed best for mitigating my risk,” Dalton told Healthline.
However, the treatment plan came as a shock to her.
“‘I hadn’t thought about mastectomy before that. It was pretty surprising and upsetting… Ultimately, I decided it was something I had to do,” she said.
At 28 years old, Dalton underwent a prophylactic double mastectomy and had reconstruction with implants.
While recovery went as expected, she didn’t anticipate losing complete sensation in her chest.
Numbness following mastectomy is common. During surgery, nerves that supply feeling to the chest are removed in addition to breast tissue.
“After I stopped hurting from the surgery, it became clear that I didn’t have sensation. Part of me thought it was a nerve-related issue that might clear up or that there was still some anesthetics that hadn’t wore off yet,” Dalton said.
After a while, she realized she wouldn’t regain sensation.
“Initially it wasn’t a big deal, and then it became a sore spot because I just wanted to feel normal and put the mastectomy in the rearview and try to live my life… like I did before,” Dalton said. “When that didn’t happen… I just didn’t feel like I was in my own body. I wasn’t 100 percent comfortable in my own skin.”
Dr. Constance Chen, a plastic and reconstructive surgeon at Lenox Hill Hospital, says reconstructive surgery typically focuses on appearance, with the goal of providing size, shape, symmetry, and softness to the restored breasts.
“Unfortunately, restoring sensation has not been a focus of breast reconstructive surgery in the past. Instead, most plastic surgeons have focused on creating two breast ‘mounds’ to obviate the need to stuff a bra when wearing clothes,” Chen told Healthline.
Dr. Mia Talmor from the division of plastic surgery at New-York Presbyterian and Weill Cornell Medicine agrees that sensation is important. But she says it’s been a focus for the past several years, particularly in reference to autologous reconstruction.
“We have noticed as we switched to less aggressive mastectomy design, and now to nipple-sparing mastectomy (which preserves all of the skin of the breast including the nipple), patients report that they regain much more sensation in general regardless of the type of reconstruction,” Talmor told Healthline.
She adds that reconnecting a sensory nerve as part of autologous reconstruction when a more aggressive mastectomy has been performed is something more plastic surgeons have been focusing on in recent years.
However, she said, “The problem is that it is very hard to study the outcomes, and so we don’t have great data to say whether or not the procedures are working.”
Ten years after Dalton’s mastectomy and reconstructive surgery, her left implant ruptured.
In her search for a surgeon who could perform natural tissue breast reconstruction, she found Dr. Chen, who suggested she undergo autologous “flap” reconstruction surgery with the technique Resensation.
Resensation uses a processed nerve allograft as a bridge to reconnect nerves in the chest to the reconstructed breast tissue. The processed nerve allograft is believed to guide regrowth of nerve fibers and help regain sensation over time.
The procedure uses skin and fat from one of part of the body and transfers it to the chest wall. Then an artery, vein, and nerve in the chest wall are secured to a nerve connecter, which reconnects the nerve from the flap and chest wall to restore sensation.
Chen explains the procedure may add 30 to 60 minutes depending on the anatomy of the patient.
“Resensation minimizes donor site numbness by using a nerve graft to optimize restoration of sensation,” Chen said. “For many women — especially young women or women undergoing prophylactic mastectomies — restoring sensation after mastectomy is life-changing.”
However, she says regaining sensation is gradual, because nerves grow a millimeter a day.
Dalton underwent the surgery in 2018.
“After healing for a few weeks, I’d feel a little pain or pinch [in my chest] and initially I thought, ‘Ouch, that hurts,’ and then I thought, ‘That’s awesome — I can feel pain, I can feel something,”’ Dalton said.
Over time, she began to feel itches or sensations when something brushed up against her chest. Slowly she gained more and more sensation. However, she never gained full sensation in her chest.
“I don’t have nipples, which is where the most sensation for me was pre-mastectomy,” Dalton said. “I have as much sensation as someone without a nipple can have.”
Chen points out that, like Dalton, some women may not regain complete sensation in their breasts, and that any sensation they do gain may feel different than what they felt with their original breasts.
She notes that risks of Resensation include all the risks of major surgery and microsurgery, including flap failure.
“Finally, some women may experience partial or temporary numbness at the donor site,” Chen said.
Talmor believes anything that restores a feeling of normalcy and comfort to a patient who has undergone a mastectomy is important.
However, she added, “Whether this procedure, which uses a commercially available cuff to reconnect the nerve, is better than just reconnecting the nerve with stitches is unknown.”
Dalton speaks about her experience to other women to spread the word.
“Many women I talk to are shocked that there is a technique like this, and that hurts my heart because that means many surgeons don’t know about this or talk about it,” Dalton said. “Regaining sensation is underestimated by many physicians.”
She hopes to see this change soon.
“I was lucky my surgeon suggested this and presented it to me. Someone who has aggressive late-stage cancer may not be concerned about sensation as much as me, who was in a privileged position to have foresight. I’m grateful I’m living in a time where there is a way to detect a gene before it’s a problem,” she said.
Regaining sensation is more about feeling to Dalton. She says it brings her closer to her pre-mastectomy body. Because she couldn’t feel her implants, she says she avoided a number of activities out of fear of rupturing them.
“Before, I wouldn’t go roller-skating or jump into a pool. Now that I have nerves and don’t have the implants in, I don’t have a shell around me. I’m more free and more adventurous,” she said.
Having feeling has also had a positive effect on her intimacy.
“It has heightened intimacy for sure, and being able to connect that much more with my partner is wonderful,” Dalton said.
While Talmor is hopeful that procedures like Resensation will help more survivors, she says women undergoing mastectomy pre- or postcancer diagnosis should keep in mind that there are many options for breast reconstruction. They should thoroughly investigate each before making any decisions.
“The decision-making is complex and should involve some research on the part of the patient and a lengthy preoperative discussion between the plastic surgeon and the patient,” Talmor said.
Cathy Cassata is a freelance writer who specializes in stories about health, mental health, and human behavior. She has a knack for writing with emotion and connecting with readers in an insightful and engaging way. Read more of her work here.