A newer technique, the nipple-sparing mastectomy is reserved for a smaller number of women with tumors that are not near the nipple areola area. The nipple-sparing procedure removes cancerous breast tissue through a small incision, usually around the areola area. This technique gives the best option for reconstruction and significantly improves the cosmetic outcome.
The surgeon will make an incision on the outer side of the breast or around the edge of the areola, and hollows out the breast, removing the areola and keeping the nipple intact. The surgeon will leave most of the breast skin, creating a natural skin envelope (or pocket) that is filled with a breast implant or with the patient’s own tissue from another part of her body. Nipple-sparing mastectomy involves simultaneous reconstruction. Sometimes the completed reconstruction is done at the same time and in other cases, a tissue expander is inserted as a space holder for later reconstruction.