Answers to Common Questions

As a breast reconstruction surgeon located in the New York Metro area, I get a lot of questions from women from all walks of life who want to learn more about their reconstructive options following mastectomy. Many women come to me from all parts of New York and across the country to learn more about skin sparing mastectomy. On this page I have put together a few of the more common questions I get about this technique. For more detailed questions or to find out if you are a candidate for this procedure, request a phone consultation with me or call the practice at 516-482-1100 to schedule an appointment.

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FAQ's about Skin Sparing Mastectomy

What is a skin sparing mastectomy?

A skin sparing mastectomy removes all of the breast tissue, consisting of glands and ducts. Since all the ducts terminate at the nipple, the nipple is considered part of the breast and therefore is usually removed. If the skin covering the breast is not involved in the cancer and has not been damaged during the course of the mastectomy, it can be saved for reconstruction.

What is the advantage of the skin sparing mastectomy and immediate breast reconstruction?

By far, the best breast reconstructions are done at the time of the skin sparing mastectomy. The pocket that the reconstruction is to be placed in already exists and does not have to be created. This is the normal breast skin and it is basically draped over the reconstruction. If all was done well, the only exposed skin from the abdomen should be to replace the nipple areola complex. Later, at a secondary surgery, the skin is replaced with the reconstructed nipple and areola. This will leave no extra scars or patches of stomach skin on the breast.

Is a skin sparing mastectomy helpful if I am going to have a delayed reconstruction (reconstruction at a later date)?

While a skin sparing mastectomy can be done even if breast reconstruction is not to be performed at the same time, it is of more limited benefit. The skin that is left behind will contract and when the reconstruction is done there will be less skin available than is needed to reconstruct the breast that was removed.

Am I taking a greater cancer risk for recurrence by having a skin sparing mastectomy?

There is no information to suggest a greater incidence of recurrence if uninvolved skin, which is a separate organ from the breast, is spared during the course of the mastectomy.

What are the problems with skin sparing mastectomy in a patient who has had a previous lumpectomy and radiation treatment?

There are two issues involved in this situation: the amount to skin available and the elasticity of the available skin. First, there is less volume in the breast that has had the lumpectomy and the skin has adjusted to this. In addition, there is less skin because the radiation treatment has caused the skin to contract. Secondly, the radiation has permanently damaged the blood supply to the skin and less of the skin, especially in a large breast, is likely to survive after the mastectomy. In patients undergoing DIEP flap breast reconstruction this would necessitate a larger patch of skin from the abdomen showing as part of the breast skin to replace the skin that is missing on the breast.

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