Can sensory nerve reconstruction be done? Is it covered by insurance?
Absolutely, it can be done and is usually covered by insurance in our experience.
During a mastectomy, nerves providing feeling to the breast are cut causing loss of sensation and numbness to the breast area. Patients undergoing mastectomy must understand they may lose all feeling to the area, regardless of whether they choose to have breast reconstruction or not. Over time, some sensation may return but unfortunately for many patients it is minimal, if any.
Mastectomy patients choosing to have DIEP flap reconstruction are candidates for an additional procedure called a "microneurorrhaphy", performed at the same time as their flap breast reconstruction. This repairs the nerves cut by the mastectomy and significantly improves return of feeling to the reconstructed breast. Microneurorrhaphy is performed by joining two nerves using microsurgery (with or without a nerve graft), and therefore requires specialized training.
Currently, very few centers offer this additional procedure.
Thank you for sharing your question. Innervation of the skin flap is being performed with greater frequency and some insurance companies are paying for the nerve graft portion of the procedure. You and your surgeon will need to discuss this with your specific plan.