Nipple Sparing Mastectomy and Reconstruction New Jersey

Nipple sparing mastectomy is a reasonable procedure choice for eligible women who are undergoing breast removal to treat cancer or as a preventative measure. This procedure is considered to be the ‘Gold standard‘ when it comes to achieving a beautiful outcome following mastectomy and immediate breast reconstruction. During a nipple sparing mastectomy and reconstruction, breast surgeons will create a small incision and use it to remove the glandular breast tissue from beneath the skin and nipple. This ensures that the overlying breast skin envelope and nipple are left intact.

Nipple sparing mastectomy usually goes hand in hand with immediate breast reconstruction using either breast implants or natural tissue. This enables a total refinement and the impression of an ‘untouched’ look right after the breast cancer treatment surgery. Our plastic surgeons at New Jersey Breast Reconstruction Center have helped countless women simplify complexities associated with having staged procedures and achieve instant results with nipple sparing reconstruction.

Skin Sparing vs Nipple Sparing Mastectomy

 

Both skin sparing and nipple sparing mastectomies focus on preserving part of the patient’s breast tissue so it can be used during reconstructive surgery. This is contrary to a traditional mastectomy where the breast tissue, nipple, and skin are all removed – leaving a noticeable scar across the chest. Skin sparing and nipple sparing techniques are usually recommended when the tumor or tumors are not close to the surface of the breast. While a skin sparing mastectomy focuses on preserving the breast skin, a nipple sparing mastectomy is a much more complex procedure because the nipple and the underlying breast tissue are connected. Our plastic surgeons at New Jersey Breast Reconstruction Center specialize on both of these tissue-preserving surgical techniques to suit the needs of different breast cancer patients.

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Immediate Breast Reconstruction

Many women who have a mastectomy or lumpectomy to treat breast cancer end up having reconstructive surgery on one or both breasts. Women who are able to have a nipple sparing mastectomy often undergo immediate reconstruction. This means that the reconstructive breast surgery is completed at the time of mastectomy. As soon as the breast surgeon is done removing the tumor or targeted tissue, the plastic surgeon will come in and rebuild the breast(s). This reconstruction may be either completed using breast implants or autologous tissue obtained from donor areas such as the abdomen, the back, or the buttocks. Most of this work is done during a single surgical session, which means the patient will wake up with rebuilt breasts (without the need for multiple surgeries).

Candidates for Nipple Sparing Mastectomy and Reconstruction

Nipple sparing mastectomy followed by immediate reconstruction is becoming a popular treatment choice because it provides good cosmetic results right after breast cancer treatment. This special surgical technique is typically available for breast cancer patients who:

  • Are keen to have immediate breast reconstruction surgery.
  • Have small, early-stage breast cancer.
  • Have relatively small cancerous cells with a tumor that is located at least a few centimeters away from the nipple.
  • Have breasts that are either small or medium in size.
  • Do not have a significant amount of breast drooping (ptosis).

Determining whether you are a candidate for nipple-sparing reconstruction is a delicate balancing act that requires the consideration of a seasoned surgeon. Our plastic surgeons partner with your breast surgeon and oncologist to assess your suitability for this treatment and draft an individualized treatment approach to achieve the best possible outcome.

Who is Not a Candidate for Nipple Sparing Mastectomy

Nipple-sparing mastectomy and immediate reconstruction offers various benefits. However, this treatment may not be for patients who:

  • Have large breasts with significant sagging.
  • Have multiple tumors in the same quadrant of the breast (or several quadrants of the breast).
  • Have a tumor that is larger than 3 centimeters.
  • Have a tumor that is located less than 2 centimeters from the nipple/areola tissue.

Other considerations such as ongoing cancer treatment may also help determine your suitability for the nipple-sparing technique.

How is the Procedure Performed

Nipple sparing mastectomy is approved by the American Society of Breast Surgeons for use on select women undergoing breast surgery. This procedure is usually performed under general anesthesia at an accredited surgical facility. The surgeon will create a small incision through which breast tissue is removed. Surgeons may use a round periareolar, a small elliptical periareolar, or periareolar incisions with inferior or lateral incisions based on the specifics of the surgery. The incision may also be placed along the bra line or outer edge of the breast. The next step is to remove breast tissue from underneath the skin envelope, preserving the overlying skin as well as the nipple and the areola. The plastic surgeon then takes over the procedure and rebuilds the breast using either implant reconstruction or natural tissue reconstruction. After the surgery is complete, you will be placed in a recovery room and observed for a while before you are transferred to a private inpatient room. Most women with breast cancer are discharged after a few nights’ stay at the hospital.

Recovery After a Nipple Sparing Mastectomy

Following this type of mastectomy, the recovery duration will vary from one patient to the other. Patients with breast cancer can expect to experience significant discomfort after this treatment. Pain medication will be provided to improve your comfort level, as well as antibiotics to prevent infection. Mild swelling and bruising are common after this breast cancer surgery but usually dissipate within a few weeks. You may also experience intermittent muscle spasms and a tight sensation around the treatment areas. You may be able to drive within 3 – 4 weeks if you are no longer using pain medication. Patients are generally able to return to light work after 6 weeks from the time of surgery. However, it is important that you avoid any type of strenuous activities for up to 10 weeks, or until you get a green light from your surgeon. Scar lines get better with time and are usually well faded within 12 – 18 months. Skin numbness is normal after surgery. The preserved nipple(s) may also be numb but usually respond to touch and temperature changes. Any lost sensation will gradually return (to a large extent) within 18 months. During this time, you may experience some itching, tingling, or mild electrical sensations that come and go as the nerves heal. Our office at New Jersey Breast Reconstruction Center will be available throughout the recovery duration to answer your questions and provide the support you may need.

FAQs

FAQ

What are the risks?

Like with any other surgical procedure, skin-sparing reconstruction comes with the risk of bleeding, wound infection, deep pain thrombosis (DVT), pulmonary embolism, and reaction to anesthesia. There is also a risk that the nipple tissue may heal poorly following the removal of breast tissue and reconstruction. Patients can minimize the risk of complications by choosing to work with a highly seasoned breast surgeon and plastic surgeon. Strictly adhering to the aftercare instructions provided by your surgeon can also go a long way to minimize the risk of postoperative complications.

What are the benefits of nipple-sparing mastectomy and reconstruction?

This surgical technique preserves the nipple-areola complex during a single or double mastectomy, resulting in better cosmetic outcomes. This procedure also results in a post-mastectomy breast that is unchanged and intact. There’s only a minimal scar in the inframammary fold, around the areola, or out toward the arm. Outside of the cosmetic advantages, data also shows that women who receive this treatment have improved self-image and higher self-esteem.

How effective is the nipple-sparing technique?

Nipple sparing mastectomy has favorable cancer-related outcomes. This procedure is highly effective when it comes to treating or preventing breast cancer. It is important to note though that this type of surgery is not for everyone. The type of cancer you have, and the nature and size of your breasts, are important considerations when assessing candidacy for nipple sparing mastectomy.