For Real Breast Reconstruction, the correct mastectomy is a critical step in the procedure.

Skin-Sparing Mastectomy
For patients with BRCA+, those with DCIS or LCIS only, and for breast cancer patients where the tumor is not directly adjacent to skin, Skin-Sparing Mastectomy is safe* (see link to article below) and cosmetically superior to traditional mastectomy.

With Skin-Sparing Mastectomy, only the nipple and areola skin is removed. The breast tissue is removed through the hole left by the areola. The reconstruction is then performed through the same small incision. In a later surgery, the nipple and areola is reconstructed, and placed so that the incision is covered, producing a scar-less result.

Before	After

Before	After

Nipple/Areola-Sparing Mastectomy
The most superior cosmetic results are obtained with the Nipple/Areola-Sparing Mastectomy. Through the crease under the breast, the breast tissue is removed and the breast is reconstructed. Not all patients are candidates for this type of mastectomy, as the nipple and areola can contain a small amount of breast ductal tissue. Often this option is chosen by currently cancer-free BRCA+ patients or women with a strong family history who would otherwise not undergo a mastectomy.

Before	After

All mastectomies are performed at Cedars-Sinai with Dr. Cassileth's colleagues who are board-certified general surgeons, specializing in breast and oncological surgery.

*	Skin-Sparing Mastectomy with Conservation of the Nipple-Areola Complex and Autologous Reconstruction is an Oncologically Safe Procedure -- article in the Annals of Surgery