Sural Nerve Graft Donor-Site Morbidity in Nipple–Areola Complex Sensory Reinnervation: A Prospective Cohort Study

Background and Objectives: Sural nerve grafts are increasingly used to restore sensation after reconstructive surgery, including nipple–areola complex (NAC) reinnervation following nipple-sparing mastectomy, but donor-site morbidity has not been characterized using combined objective and patient-reported measures. We quantified this morbidity prospectively. Materials and Methods: Ten women who had undergone mastectomy with direct-to-implant reconstruction and NAC reinnervation using a sural nerve graft were assessed by photographic mapping of the donor-site deficit, the FootQ symptom and scar-satisfaction questionnaire (preoperatively, 6 months, 1 year), sural nerve conduction studies (NCS) at 12 months (at 10 months in one patient), and bedside Semmes–Weinstein monofilament and two-point discrimination (2PD) testing. Spearman correlation, Wilcoxon signed-rank, and Friedman tests were used.