Nipple Sparing Mastectomy Reconstruction with Free Nipple Grafts, Raleigh, NC

Procedure Details

This 58-year-old woman had genetic predisposition to breast cancer with a positive BRCA gene mutation which put her at high risk of development of breast cancer. She chose bilateral prophylactic mastectomy with reconstruction. Her case was challenging. She had large pendulous breasts and desired smaller breasts. Nipple sparing mastectomy is frequently offered to patients with BRCA however her nipple positions were low and not conducive to maintenance on their own blood supply. Therefore Dr. Lyle, performed a nipple preservation technique which involved removal of her nipples at the beginning of the operation as full thickness skin grafts. The mastectomy skin was then tailored much like a breast reduction to conform to smaller size breasts. The nipples were replaced by a skin graft technique at the end of the procedure. She had a 2 staged reconstruction with tissue expander and allograft followed by insertion of permanent implants approximately 5 months later. The result is a smaller more lifted-appearing breasts with her own nipples preserved. Although the nipples do not maintain sensation, they still appear natural and maintain some degree of responsiveness to touch because of the nature of the full-thickness skin graft tissue which maintains myofibroblasts. Although the decision to remove the breasts without existing cancer is difficult, advanced reconstructive techniques make that choice easier for patient's considering this surgery.


REX Hospital

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.