In a standard mastectomy, the surgeon removes the entire breast, including the nipple-areolar complex. Breast reconstruction patients in Fairfax and Northern Virginia have several options for recreating the nipple. These procedures generally provide aesthetically appealing and natural-looking results. However:
- Some women prefer to preserve as much of their original breast as possible, including the nipple and areola.
- Certain options for recreating the nipple require an additional surgery. While this surgery generally isn’t terribly painful, patients may not want to have a follow-up procedure.
- Some procedures for reconstructing the nipple and areola leave additional scars and create results that are not as natural appearing or lasting as the native nipple.
Nipple sparing mastectomy is a technique that allows Fairfax and Northern Virginia patients to keep their nipple and areola following the removal of their breast. The approach is relatively new, but its advantages make it a popular option for breast reconstruction patients. Incisions frequently are placed in the inframammary fold: the natural fold beneath the breast. As a result, the nipple, areola, and visible breast do not have any obvious scarring.
Two factors, described below, determine whether you may be a candidate for the procedure.
The Location of the Breast Cancer
I coordinate patients care in Fairfax and Northern Virginia with their breast cancer surgeon. Together, we establish the best schedule, approach, and techniques for surgery and reconstruction.
Your breast cancer surgeon should be able to identify the location and number of cancerous areas in the breast. If the cancer is too close to the nipple, it is likely that the nipple will need to be removed. If the cancer is not too close, you may be able to receive a nipple sparing mastectomy.
The Size of the Breast
Reconstruction patients with smaller breasts are better candidates for nipple sparing mastectomy.
When your surgeon removes the breast, the overlying skin loses a lot of its blood supply. The surrounding tissue can provide an alternative supply to this skin. However, if you have large breasts, your nipple and areola may be too far away to get the blood supply that they need.
If you have smaller breasts, this may not be a problem. The nipple and areola will be close enough to skin that is still receiving a good blood supply to benefit. As part of your breast reconstruction consultation in Fairfax / Northern Virginia, I can evaluate your needs.
Should You Consider Nipple Sparing Mastectomy?
The procedure offers some clear benefits, but it’s important to remember that breast reconstruction is about your goals and choices. Many of my patients are very happy with the results that nipple reconstruction offers, and some choose not to reconstruct the nipple at all.
Also, I sometimes recommend that nipple sparing mastectomy patients begin with a tissue expander rather than a breast implant. I use this conservative approach to protect the blood supply to the nipple and the areola. For some patients, this is absolutely fine, while others prefer not to go through the process of having a tissue expander, and they opt out of nipple sparing mastectomy as a result. I can help you explore different approaches to shape the experience you want.
Find out whether you are a candidate for nipple sparing mastectomy and learn about your other options with breast reconstruction. Fairfax and Northern Virginia patients can schedule a consultation with Dr. Jespersen by calling (703) 992-7969 or completing our contact form.