Skin-Sparing Mastectomy
What Is a Skin-Sparing Mastectomy?
A skin-sparing mastectomy is a type of breast cancer surgery that removes the breast tissue while preserving most of the outer breast skin. Unlike a traditional mastectomy, which removes the nipple, areola, and skin, this approach keeps the natural skin envelope intact, creating a more favorable foundation for reconstruction.
Skin-sparing mastectomy is often recommended when nipple preservation is not oncologically safe, but maintaining the breast skin can support improved reconstruction outcomes. When paired with advanced reconstruction techniques, this approach can help restore a natural breast shape while prioritizing cancer treatment.
Key Information
- Preserves the majority of the breast skin while removing all breast tissue
- The nipple and areola are removed, but the skin envelope remains intact
- Often recommended when nipple-sparing mastectomy is not appropriate
- Creates an optimal foundation for immediate breast reconstruction
- Can be safely combined with natural tissue or implant-based reconstruction
- Supports improved cosmetic outcomes compared to traditional mastectomy
- Does not compromise cancer treatment when performed in appropriate candidates
What to Expect During Surgery
During a skin-sparing mastectomy, your surgeon removes the breast tissue through carefully planned incisions while preserving most of the outer breast skin. The nipple and areola are removed, but the remaining skin is maintained to support reconstruction.
The preserved skin allows the reconstructive surgeon to restore breast shape more naturally, whether reconstruction is performed using natural tissue or implants. As with all mastectomy procedures, the primary goal is complete cancer removal while optimizing reconstructive outcomes.
A skin-sparing mastectomy without reconstruction typically takes a few hours. When combined with immediate reconstruction, total surgery time will vary based on the reconstruction method used.
Before & After
Recovery Timeline
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Week 1:Expect soreness, swelling, and fatigue, particularly in the chest area. If reconstruction was performed at the same time, you may also feel tightness or discomfort related to the reconstruction site. Most patients return home the same day or after an overnight stay. Surgical drains are common during this period and will require daily care. Pain is typically well controlled with medication, and short, gentle walks are encouraged to support circulation and healing.
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Week 2:Swelling and discomfort usually begin to improve, though fatigue is still common. Drains may remain in place depending on healing progress. Light daily activities can be resumed, but lifting, reaching overhead, and strenuous movements should still be avoided. Follow-up visits during this time focus on incision healing and drain management.
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Weeks 3-4:Many patients experience a noticeable increase in energy and mobility. Drains are often removed during this period. Swelling may persist but continues to gradually resolve. Patients who had reconstruction may begin gentle range-of-motion exercises if cleared by their surgeon. Scar care instructions are typically introduced.
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Weeks 5-6:By this stage, most patients return to many normal daily routines, including work that is not physically demanding. Incisions continue to mature, and discomfort is minimal for most patients. Activity restrictions may gradually ease, depending on the type of reconstruction performed.
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Week 6 and Beyond:Most patients are cleared to resume regular activities, including exercise, with guidance from their surgical team. Internal healing continues for several months, particularly if flap-based reconstruction was performed, but patients often report feeling more like themselves as strength and comfort return.
Am I a Candidate for a Skin-Sparing Mastectomy?
A skin-sparing mastectomy may be an excellent option for patients who are not candidates for nipple-sparing surgery but still wish to preserve as much of the breast’s natural appearance as possible through reconstruction.
You may be a strong candidate for a hidden scar mastectomy if:
- Cancer involves or is close to the nipple or areola
- Nipple preservation is not considered safe
- You plan to undergo immediate breast reconstruction
- You have not had extensive prior radiation to the breast
- You are medically cleared for surgery and reconstruction
- You want improved cosmetic outcomes compared to a traditional mastectomy
Find Your Surgeon
Will Insurance Cover a Skin-Sparing Mastectomy?
Yes. Most insurance plans cover skin-sparing mastectomy as part of medically necessary breast cancer treatment. Under the Women’s Health and Cancer Rights Act (WHCRA), coverage includes mastectomy procedures and any required reconstruction.
At PRMA, we work closely with your insurance provider to ensure coverage is clearly understood and your care is as stress-free as possible. You deserve access to the treatment that’s right for you, and we’re here to help make that happen.
For more information, visit Insurance FAQs in the patient resource center.
Preparing for Skin-Sparing Mastectomy Surgery
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