Mastectomy Surgery - Comparing Types of Mastectomies

Nipple and skin sparing techniques can be used in combination with most mastectomy surgeries to retain more skin than is done in a traditional mastectomy. A general guideline for retaining the nipple, areola and additional skin is this: The area of cancer should be a minimum of two centimeters away from the tissue that is to be saved. Therefore, a patient whose cancer is affecting the skin or nipple would not be a candidate for having those tissues retained after surgery.

Skin Sparing Mastectomy

This technique preserves the skin of the breast, but not the nipple and areola, which are removed. The breast tissue is then removed through that area. For women with large breasts, an additional incision may be made to allow the breast tissue to be removed, but the vast majority of skin is left behind after surgery.

Nipple Sparing Mastectomy

The incision to remove the breast tissue is made around the areola, thus preserving both the nipple and areola. This procedure, like the skin sparing procedure, may result in a larger incision than is necessary in the traditional procedure, especially if the breast is large in size. It's important to note, however, that the nipple contains breast tissue that is still at risk for forming breast cancer. Therefore, it must be screen for cancer on an annual basis.

Total Skin Sparing Mastectomy

This procedure, also known as a subcutaneous mastectomy, not only preserves the skin of the breast, but the nipple and areola, too. The incision to remove the breast tissue can be placed in the fold under the breast where it cannot be easily seen once healed, or the incision may be made around the areola.