Traditionally, mastectomy for breast cancer involved surgical removal of the tumor and remaining breast tissue, which resulted in a long, unsightly scar across the chest. With the advent of minimally invasive surgical techniques, a long scar can be avoided. In a skin-sparing mastectomy, the breast tissue is surgically removed while leaving most of the skin intact. To thoroughly remove the breast tissue, the nipple and areola also need to be removed.
The skin-sparing mastectomy places a small incision either around the areola or in a lollipop-like shape so that the resulting scar is completely below the level of the nipple. Through this procedure, total removal of the tumor and breast tissue is possible without the removal of healthy breast skin. Whenever feasible, the incision around the areola can be made on the breast in a manner consistent with accepted practice in breast cosmetic surgery.
After a skin-sparing mastectomy, the empty skin envelope can be tailored to an optimal shape by the reconstructive plastic surgeon. This procedure can also correct pre-existing problems such as breast droopiness and poor shape. The skin envelope is filled with either the patient's own tissue, an implant, or a combination of the two.