In skin-sparing mastectomy, the entire breast, nipple and areola are removed without removal of the breast skin. The surgeon makes a small incision around the areola that maintains the rest of the breast skin to optimize the results of cosmetic reconstruction.
Skin-sparing mastectomy is often performed when breast removal and reconstruction are completed during the same operation. If an axillary dissection or a sentinel lymph node biopsy is necessary, another incision is often made under the arm.
A skin-sparing mastectomy with breast reconstruction takes two to six hours, depending on the type of breast reconstruction performed.
After skin-sparing mastectomy, small drainage tubes are placed in the breast area to draw off fluid. The ends of these drains are attached to a pocket-sized suction device. Patients are instructed in the care and monitoring of the drainage until the drains are removed, a week or more after surgery.
The hospital stay after skin-sparing mastectomy and reconstruction is usually one to two nights, unless tissue reconstruction is performed.
The pain level following skin-sparing mastectomy with reconstruction is generally greater than the pain level following a simple or total mastectomy. Patients often use prescription pain medication for the first two weeks following surgery and then use an over-the-counter pain reliever as needed.
Numbness may occur under the arm if an axillary dissection (removal of lymph nodes in the armpit area) is performed. Some numbness may fade over time.
Patients generally are advised to expect fatigue and plan a light schedule that includes daily naps for the weeks following skin-sparing mastectomy. Cancer surgery is emotionally draining and physically taxing.