A simple mastectomy, also known as a total mastectomy, is a procedure that removes all of the breast tissue of the affected breast. The most common form of the surgery, referred to as traditional total mastectomy, includes the removal of the areola and nipple. However, the surgery can be performed using skin and nipple sparing techniques. It also leaves the muscle under the breast left intact.
The procedure is performed using an elliptical incision 6 to 8 inches in length that begins on the inside of the breast, near the breast bone, and extends upward and outward toward the armpit. The incision can also be altered to remove scar tissue from previous procedures, which can improve the cosmetic outcome if reconstruction is desired.
Once the breast tissue is removed, the incision is closed with either absorbable sutures, which the body slowly absorbs over time, or staples that are removed during an office visit 10 to 14 days after surgery. There may also be a drain, a device that helps remove excess fluid from the body to promote healing and decrease swelling, in place. The drain will be under a bandage to protect the surgical site and the drain placement. In most cases, the drain will be removed during an office visit after discharge from the hospital.
When this type of mastectomy is combined with an additional procedure to remove lymph nodes from under the arm it is called a modified radical mastectomy. It, too, can be paired with a breast reconstruction procedure.