About Nipple-sparing Mastectomy with Reconstruction

In a nipple-sparing mastectomy the breast tissue is removed while the nipple and/or areola remains. Nipple-sparing mastectomy (NSM) is becoming increasingly popular as an alternative for early stage breast cancer and prophylactic mastectomy. In the right circumstance, nipple preservation can provide a reconstructive result that is unparalleled to any other option currently available. The preservation of the nipple can allow for less scarring, less surgery (eliminating the need for nipple reconstruction), and a more natural and normal looking breast reconstruction.

Candidacy for Nipple-Sparing Mastectomy

Oncological: Candidacy for nipple preservation in cancer patients is primarily related to the characteristics of the breast cancer being size, location, and distance from the nipple.

For patients undergoing prophylactic mastectomy, nipple preservation is generally thought to be a reasonable alternative.

Reconstructive: There are also reconstructive and anatomical considerations that should be taken into consideration. The ideal candidate for nipple preservation from a reconstructive point of view would be a patient with relatively smaller breasts with nipples located at approximately the center of the breast. Very large breasts with extremely sagging nipples present certain challenges to successfully achieving nipple preservation.