Nipple Sparing Mastectomy
Our surgeons have a particular interest in this operation. Nipple Sparing Mastectomy (NSM) as the name suggests, aims to preserve all of the skin envelope of the breast including the skin of the nipple areolar complex (NAC), while at the same time removing the same amount of breast tissue that normally would have been removed in a simple mastectomy.
Preserving all the skin envelope opens up the possibility of a direct to implant reconstruction (DTI), i.e. the whole mastectomy and reconstruction with a silicone breast implant can be achieved in a single operation in many cases. Your surgeon may recommend a 2 stage procedure especially if you are aiming for a larger result than your native breast size, or if you have risk factors that make you at higher risk of complications. NSM is becoming an increasingly popular option chosen by patients especially in the setting of risk reducing mastectomies (removal of the breast(s) before it can develop cancer); it is however for technical reasons not suited to all patients and your surgeon will help guide you as to what the best options for you are. Broadly speaking NSM is offered to women who have < D cup bra size. Most patients will require a 1-3 night stay in hospital following this sort of surgery & a further approximately 4 weeks of no heavy lifting to allow the implants to settle into position and for a natural capsule to start forming around the implant. As with any complex surgery there is a risk of complications and your surgeon will give you an estimate of your likely risk of both minor and major complications based on your personal assessment. The two most dramatic short term complications are implant loss due to infection and loss of the nipple due to lack of blood supply. These are uncommon problems but everyone undergoing this procedure needs to understand this small but important risk. In the longer term there is a small risk of progressive capsule contracture. All implants will develop a capsule around them. This is normal. For most patients this will be soft. Sometimes the normal capsule becomes excessively thick and/or tight resulting in pain and/or misshaping of the implant. If this does happen it can usually be corrected but will typically require further surgery.