Nipple sparing mastectomy NJ
Traditionally the mastectomy included the nipple because the nipple is part of the breast and the milk ducts continue into the nipple. Recently it has been shown that when the tumor is small and far from the nipple, saving the nipple is possible and does not change the prognosis. Because the nipple is such an important part of the breast, saving it reduces the psychological impact of the mastectomy and makes the procedure more acceptable to women. With the great advances in breast reconstruction, today it is possible to create a breast that looks natural and when the nipple is preserved, one could believe that a mastectomy was never done. See picture below. There is no question that nipple-sparing mastectomy and immediate reconstruction is very popular and is often requested by the patient, at least in northern New Jersey where I practice. I try to accommodate this demand whenever possible, but it is important to let the potential patients know about the limitation of this operation.
This patient had bilateral nipple sparing mastectomy and bilateral immediate reconstruction through an incision under the breast.
The following are some of the absolute or relative contraindication to nipple preservation.
- Nipple sparing is not considered safe when the tumor is too close to the nipple.
- When the tumor is too large, usually over four centimeters.
- When the breast is too redundant (ptotic) with too much breast skin. In this case, the nipple areola needs to be lifted and it is difficult to maintain its blood supply.
- In cases when the nipple is not ideally positioned on the breast and relocation is desired.
- In cases when the nipple is too large and a change in size is desired.