PROCEDURES / BREAST RECONSTRUCTION​

Skin-Sparing Mastectomy
on Long Island

A skin-sparing mastectomy is a surgical procedure used in breast cancer treatment and prevention. This procedure involves the removal of all breast tissue – including the fat, ducts, glands, nipple, and areola – while preserving as much of the overlying breast skin as possible. Leaving more of the breast skin envelope during a mastectomy can help maintain a more natural appearance during reconstruction and reduce scarring. If you plan to schedule an immediate reconstruction with your plastic surgeon, a skin-sparing mastectomy could be the right choice.

Are You a Candidate for Skin-Sparing Mastectomy?

The decision to get a mastectomy can be an extremely difficult one. Depending on your circumstances, you may be best suited for a nipple-sparing mastectomy or a skin-sparing mastectomy.
Skin-Sparing Mastectomy – Candidate Qualities
Good Candidate Not A Good Candidate
  • Early Stage Breast Cancer If nipple-sparing surgery isn’t an option, based on the proximity of the cancer to the nipple or based on excessive breast drooping, a skin-sparing mastectomy could be a good choice.
    • Women considering a prophylactic mastectomy should evaluate whether a nipple-sparing procedure is more appropriate.
  • Poor Blood Supply Smokers or those with vascular conditions may have inadequate wound healing after skin-sparing mastectomy, which increases the risk of complications. Delayed reconstruction may need to be considered to make certain the mastectomy flap skin is alive, and an implant can safely be placed beneath it.
  • No Skin Involvement If the tumor is not near the skin, there is a better chance of preserving the breast skin while eliminating the cancer.
  • Skin or Nipple Involvement If the nipple or skin of the breast has cancerous growth, the tumor has spread too much to preserve the overlying skin.
  • Tumor Characteristics Small localized tumors with clean borders that aren’t near the skin are well suited to nipple-sparing or skin-sparing techniques.
  • Previous Radiation Therapy Radiation therapy can hinder blood supply to the remaining skin; other mastectomy options should be considered.
  • Adequate Blood Supply Blood flow to the skin must be plentiful enough for proper wound healing.
  • No Planned Reconstruction Skin-sparing mastectomy is often performed with immediate breast reconstruction. If you are not a candidate or prefer not to have a reconstruction, an aesthetic flat closure, which removes all loose breast skin, creating a flat contour, might be a better option.
  • No History of Radiation Therapy Radiation therapy can damage the skin’s blood vessels and increase the risk of surgical complications.
  • Planned Immediate Reconstruction Preserving the skin envelope is ideal for immediate reconstruction to maintain the natural shape of the chest.
The primary goal of a skin-sparing mastectomy, or any mastectomy, is to balance patient health by eliminating the risk of cancer (development, spread, or recurrence) and achieving the best possible cosmetic outcome and quality of life.
woman practicing self-care after skin-sparing mastectomy

A Multidisciplinary Approach Begins With a Plastic Surgeon Consultation

Deciding to undergo a skin-sparing mastectomy should be made in consultation with a multidisciplinary team of healthcare professionals, including a plastic surgeon, breast surgeon, and oncologist. Each case is unique, and the treatment plan must be tailored to the individual’s circumstances, preferences, and medical history.

Beginning your planning by consulting a plastic surgeon soon after cancer diagnosis (or as soon after a detected genetic predisposition to breast cancer) can provide additional benefits to living a cancer-free life. Plastic surgeons are experts at:

  • Planning your mastectomy with the reconstruction in mind, offering better aesthetic results.
  • Coordinating with a team of highly skilled breast surgeons and oncologists.
  • Assisting patients with questions about insurance benefits and getting the most from their coverage.
  • Providing skilled medical attention with training in microsurgical techniques and oncoplastic surgery.

When you schedule your consultation at Harris Plastic Surgery, Dr. Harris will develop a treatment plan that is fully personalized to your medical history, breast cancer risk, anatomy, preferences, and goals. He knows that the decision to get a mastectomy is life-changing, so he and his staff are ready to provide you with the support and information you need to make the best decisions possible.

Frequently Asked Questions About Skin-Sparing Mastectomy

In a traditional mastectomy, all breast tissue, including the skin, ducts, nipple, and areola, are removed. Skin-sparing mastectomy, by contrast, preserves most of the overlying breast skin, which can lead to better aesthetic results when paired with immediate reconstruction.

The main benefit of skin-sparing mastectomy is the potential for better cosmetic outcomes, as the preserved skin allows for more natural-looking breast reconstruction. This can be psychologically beneficial for some women, helping them maintain their positive body image.

Immediate reconstruction is often possible using implants or autologous tissue transfer. The intact skin allows for a more natural shape and appearance in the final reconstruction.

Recovery time varies depending on the individual and whether reconstruction is performed at the same time. Generally, you may have to stay in the hospital for 1-3 days, with your full recovery taking several weeks to a few months.

Studies suggest that the risk of cancer recurrence after a skin-sparing mastectomy is similar to that of a traditional mastectomy. However, you will need to discuss your specific case with your oncologist and breast surgeon.

Unfortunately, yes, most women lose sensation in their breasts after mastectomy, including in the preserved skin. Some women might experience some return of sensation over time, but this is generally limited. With a skilled surgeon who can preserve the sensory nerves of the chest during mastectomy, some resensation procedures may be possible.

Your surgeon will provide you with specific instructions, which may include quitting smoking, stopping certain medications, not eating or drinking before surgery, and arranging for help at home during recovery.

Whether radiation therapy is needed depends on several factors, including the stage and characteristics of your cancer. If necessary, radiation can usually be administered after the mastectomy and reconstruction.

Yes, skin-spring mastectomies can be performed on women with larger breasts, although the surgical approach may differ. Your plastic surgeon may discuss additional procedures, like skin envelope reduction pattern mastectomy, wherein the skin is reduced similarly to the way it is reduced in a breast reduction, as part of the process.

Consulting with a plastic surgeon before your mastectomy is the best way to get a clear idea of your post-reconstruction results. Most women with realistic expectations are satisfied with their cosmetic results, especially when immediate reconstruction is performed. The preserved skin helps achieve a more natural-looking breast.
Choosing a plastic surgeon with experience in skin-sparing mastectomy and breast reconstruction can significantly impact the success of the procedure and the quality of cosmetic results. Ensure your plastic surgeon has expertise in all breast reconstruction and revision techniques.

Dr. Harris, of Harris Plastic Surgery, has made a name for himself as one of the top breast reconstruction surgeons because of his total focus on patient care and dedication to impeccable results.

Contact us online or by phone/text if you have questions or are ready to schedule your consultation today.

CONTACT

Stephen U. Harris, MD FACS

Dr. Stephen U. Harris is a board-certified cosmetic surgeon and recognized expert in breast reduction and reconstruction surgeries, having performed thousands in his career. When it comes to patient care, his philosophy is that every surgery should improve his patient’s overall quality of life, not just their appearance. Dr. Harris stays up-to-date on all the latest advancements in breast augmentation, reconstruction, and reduction and is a recognized innovator in the field. In fact, he was the first surgeon at Good Samaritan Hospital to offer primary prepectoral implant breast reconstruction, as well as secondary prepectoral revision surgery.

Dr. Harris also serves as Chief of Plastic Surgery at Good Samaritan Hospital in West Islip, New York and is an active staff surgeon (and former Chief of Plastic Surgery) at South Shore University Hospital in Bay Shore, New York.