Skin Sparing Mastectomy

During immediate reconstruction, it is often possible to perform a 'skin-sparing mastectomy'. This involves removing the nipple and the entire breast contents, but leaving most of the breast skin behind.

The scars after immediate reconstruction are either a circular scar around the nipple and areola (darker skin around the nipple) or a relatively small straight-line scar. Skin sparing mastectomy techniques have been shown to be safe and result in better cosmetic results. Not all patients who require a mastectomy are suitable for a skin-sparing approach.

In contrast, delayed reconstruction requires the skin left after mastectomy to be stitched up. It is not possible to use this skin for reconstruction as, during the months between the two procedures, it would shrink and scar to the muscle underneath resulting in hard, non-malleable skin and a very poor cosmetic result of the breast surface following reconstruction.

More skin is, therefore, removed at the time of mastectomy, resulting in a long scar across the chest wall. Although this scar will fade in time, it will always be present, even after reconstruction.