Mastectomy Options

A skin-sparing mastectomy (SSM) is a type of breast surgery where the breast tissue, nipple, and areola are removed, but most of the natural breast skin is preserved. This skin “envelope” makes it easier to rebuild the breast with reconstruction, often resulting in a more natural contour.

How It Works

During a skin-sparing mastectomy:

• The surgeon removes the breast tissue along with the nipple and areola.

• The majority of the breast skin is left in place.

• Reconstruction (with implants, natural tissue flaps, or both) is usually performed at the same time, filling the preserved skin envelope.

This approach avoids the need for large patches of replacement skin and helps the reconstructed breast look smoother and more natural.

Who May Be a Candidate

Skin-sparing mastectomy is an option for many women, but safety depends on the location of the cancer and your overall treatment plan. It may be recommended if:

• The cancer does not directly involve the skin.

• You are planning immediate breast reconstruction.

• You are undergoing mastectomy for early-stage breast cancer or as a preventive (prophylactic) surgery due to genetic risk.

Your surgeon will carefully evaluate whether keeping the skin is safe in your case.

Benefits of Skin-Sparing Mastectomy

• More natural reconstruction: Preserving skin gives surgeons a better “canvas” for shaping the breast.

• Fewer scars: Keeping the skin reduces the need for skin grafts or patches from other body areas.

• Flexibility: Works well with both implant-based and flap-based reconstruction.

• Emotional benefit: Many women feel more confident with a reconstructed breast that has a natural outer contour.

Things to Keep in Mind

• Nipple and areola are removed: Unlike nipple-sparing mastectomy, these cannot usually be preserved. However, they can be recreated later through nipple reconstruction or 3D tattooing.

• Not for every case: If cancer is very close to or involving the skin, a different type of mastectomy may be recommended.

• Sensation changes: Even though the skin is preserved, most women lose sensation in the breast and nipple area after surgery.

• Reconstruction usually immediate: Skin-sparing mastectomy is most often performed together with reconstruction; it’s less common to delay.

Emotional Considerations

Many women appreciate that skin-sparing mastectomy allows their reconstructed breast to look more natural under clothing and in the mirror. Others may feel disappointed by the loss of the nipple or changes in sensation. Both reactions are normal, and support is available as you navigate your healing journey.

A Personal Choice

Skin-sparing mastectomy preserves what it safely can, making reconstruction feel smoother and more natural—while still putting your health first. It is one of several surgical options available after a breast cancer diagnosis or for women at high genetic risk. For those who want reconstruction, it can provide excellent cosmetic results while still ensuring safe cancer removal.