Skin-Sparing Mastectomy

A skin-sparing mastectomy is a surgical procedure used in breast cancer treatment and prevention that 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 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.

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 oncologists. 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 diagnosis of a genetic predisposition to breast cancer when considering prophylactic mastectomy 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.

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