Nipple preserving mastectomy with Hidden scar

Advances in women's breast cancer care have come along way in the past 25 years. Techniques using silicone implants and expanders  have improved as well. Using Acellular dermal matrix (ADM) to support the implant has improved longterm results and decreased the frequency of hardness around the implant.
      When a woman chooses a surgeon to perform nipple sparing surgery, the patient needs to be an ideal candidate herself. Previous biopsy scars can compromise healing and need tot be carefully considered. Smoking, high blood pressure,diabetes add risks as well. An experienced surgeon should be able to show you many before and after cases. You should be given the opportunity to talk to prior patients who are willing and HIPPA consented for patient education. We truly want to know your options, recovery, and expected outpatient care.
       Multiple opinions can be helpful,especially when considering bilateral breast surgery with reconstruction. Patients need to understand that delayed, immediate reconstruction can be a valuable option. Although, I like to perform nipple sparing mastectomy with immediate silicone implants, most plastic surgeons use expanders when working with other breast surgeons. 10-15% of those patients can have slow healing skin complications. Yes, there are many causes of healing problems in the skin and nipple. This is why experience matters. See several similar cases and review other options. Before and after photos showing a staged or delayed approach can help women understand their choices.

      My ideal candidate is a women with positive BRCA testing or other precancerous disease that is healthy and active. A thorough medical evaluation and exam with breast and chest measurements will help plan our implant, ADM selection. We use several approaches to minimize scarring and hide from frontal view whenever possible. Intraoperative nerve blocks and advanced preoperative protocol make outpatient care efficient. Careful office follow up for shoulder activity and motion after reconstruction is critical for resuming full activity. Do your home work and investigate your options.