Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning.

TLDR

Skin‑sparing mastectomy preserves most of the skin while removing breast tissue. The authors performed skin‑sparing mastectomies that included the nipple‑areola complex, biopsy site, and axillary access, with immediate reconstruction using Wise‑type patterns for large breasts and minimal, non‑continuous incisions for small breasts to reduce scarring. Appropriately applied skin‑sparing mastectomy markedly improves breast aesthetic outcomes.

Abstract

Skin-sparing mastectomy by definition describes the procedure of mastectomy, either simple or modified radical, with a minimum amount of skin excision. The surgical skin excision must: (1) include the nipple-areola complex, (2) include the biopsy site, and (3) allow for access to the axilla for possible dissection. In 27 mastectomies, the senior author has had direct input in the preoperative skin planning. All patients underwent immediate breast reconstruction. In large-breasted women, the mastectomy was performed to a Wise-type pattern. In small-breasted women, the mastectomy involved minimal skin excision followed by reconstruction. Non-continuous incisions were frequently used in small-breasted women, thereby minimizing breast scarring. When appropriately applied, skin-sparing mastectomy can greatly improve the final aesthetic result of the breast.