A retrospective review of case records was performed of 110 patients who underwent 124 total duct excisions during the period 1989–1995. All patients were sent a questionnaire and 88 fully completed questionnaires from 100 total duct excisions were analysed. All operations were performed according to a standard technique utilizing a circumareolar incision and all operations were performed under antibiotic cover. Immediate postoperative wound morbidity was low with only 4 wound infections. Of the 100 operations assessed from the questionnaires, 94 patients rated the cosmetic result as excellent or good. Nipple sensation improved after 24 operations but decreased or was absent after 26 operations. Patients who reported pain prior to operation, those who smoked and those who had a past history of multiple episodes of periareolar sepsis were significantly more likely to have decreased nipple sensation following surgery (P = 0.045, P = 0.015 and P = 0.007, respectively). Patients who reported that the position of the nipple was improved by surgery were significantly more likely to report improvement in nipple sensation (P = 0.01). Total duct excision is an operation that can be performed with acceptable postoperative wound complications but is associated with significant changes in nipple sensation, and patients should be warned of this.