Skin-Sparing Mastectomy

Overview

A mastectomy is a type of surgery used to treat breast cancer or to prevent breast cancer in women at high risk for breast cancer. During the surgery, as much breast tissue as possible is removed. In the past, this surgery caused a long scar across the chest. Now, less invasive surgery methods are used to improve the appearance of the reconstructed breast.

In a skin-sparing mastectomy, the breast tissue is removed while most of the healthy breast skin is left. This method is used only if the patient will have immediate breast reconstruction. If surgery to rebuild the breast will happen later, more breast skin will be removed. This will make sure the scar and chest surface are flat.

1. 1. When you get to the hospital, you will change into a hospital gown and remove any jewelry or other personal items prior to surgery. You may want to leave these at home in fact.
2. 2. The surgical team will explain the procedure and answer any of your questions prior to giving your written permission for surgery.
3. 3. You will be taken to the operating room and given general anesthesia to help you fall asleep.
4. 4. Once you are asleep, the surgeon will make a small incision around the areola.
5. 5. The breast tissue will then be removed through the skin incision. To thoroughly remove the breast tissue, the nipple and areola may also need to be removed.
6. 6. Samples of the tissue will be sent to a pathology specialist.
7. 7. The reconstructive surgeon will shape the remaining skin and begin rebuilding the breast. The breast may be rebuilt using implants, your own tissue or temporary tissue expanders.
8. 8. The incision is closed. A small plastic tube, called a drain, may be sewn into place under the skin in order to collect fluid normally produced by the body from this surgery.
9. 9. Lymph nodes may also be removed to be checked, if deemed necessary by the surgeon.
10. 10. Sometimes, the nipple and areola can be saved if your surgeon feels it is safe to do so.

This procedure can also correct pre-existing problems such as breast droopiness and poor shape.

Risks associated with a mastectomy include:

• Bleeding
• Infection
• Pain
• Swelling in the arm, known as lymphedema, if lymph nodes have been removed
• Formation of hard scar tissue at the surgical site
• Shoulder pain and stiffness
• Numbness, particularly in the underarm, from lymph node removal
• Buildup of blood in the surgical site (hematoma)

There are a couple of options for the breast reconstruction portion of the surgery:

• Temporary expanders. These are placed behind the chest muscles. These temporary implants expand the area and create space for implant reconstruction. This method is often used when the woman will have radiation therapy after surgery.
• Breast implants. These are placed in the area that once held the breast tissue. These implants are made of synthetic materials such as silicone.
• Tissue flap. Some women may be able to use tissue or fat from other areas of their body to reconstruct the breast shape.

Get general information about your surgery and procedure.

You will likely stay in the hospital overnight and be sent home with the drainage tubes. Your doctor may prescribe antibiotics and pain medication. The drains will be removed at your postop visit.