The importance of the mastectomy is often overlooked when discussing breast reconstruction. The primary and most important role of a mastectomy is to remove the breast cancer. However, the quality and/or type of mastectomy can have a significant effect on the esthetic result of a breast reconstruction. Therefore, it’s important to discuss the following mastectomy options if you are considering immediate breast reconstruction.

Skin-Sparing Mastectomy:

A skin-sparing mastectomy is performed by removing the breast with the entire nipple and areola, leaving behind as much skin as possible. The technique was developed to facilitate immediate breast reconstruction, where the remaining skin is used to cover either the implant or flap tissue. The development of the skin-sparing mastectomy has led to less visible scars and improved breast shape.

Nipple-Sparing Mastectomy:

A nipple-sparing mastectomy is used to describe a mastectomy which preserves the nipple/areola complex, along with the entire breast skin. In effect, the only component removed is the glandular and fatty tissue of the breast. Leaving the nipple and entire skin envelope behind for an immediate reconstruction can produce some of the most natural-looking breasts. As a result, nipple-sparing mastectomy has become the procedure of choice in prophylactic mastectomy patients. In select cancer patients where the tumor is small and located away from the nipple, nipple-sparing mastectomy can also be performed safely.

Skin-Reducing Mastectomy:

A skin-reducing mastectomy is most often performed in women with large or sagging breasts who wish to undergo immediate reconstruction. In these cases, there is simply too much breast skin. Techniques to reduce the breast skin envelope and reconstruct immediately are now referred to as skin-reducing mastectomies. Refinements in this technique have led to less visible scars and improved cosmetic results.