Mastectomy involves removal of all of the breast tissue. The muscle on the chest wall is not removed. Removal of the breast causes the breast skin to lose sensation. Mastectomy techniques may vary depending on the size and shape of your breast and the location of your cancer. In some cases, the nipple can be spared (nipple sparing mastectomy). In most cases, sentinal lymph node dissection and lymph node dissection, if indicated, is performed at the same time as the mastectomy.
Skin Sparing Mastectomy
With this technique, the inner breast tissue and nipple are removed, but the skin is maintained. This usually results in a scar that runs from the previous location of your nipple out towards the armpit.
Reconstruction would also take place through this scar. Depending on the type of reconstruction you have, the location or appearance of your scar may change.
Nipple Sparing Mastectomy
For certain women with small cancers, or cancers that are far enough away from the nipple, the nipple can be spared. Although the nipple will not have normal sensation, this can result in a more natural appearing breast reconstruction. Nipple sparing mastectomy also reduces the number of surgeries needed to complete reconstruction. Scars may vary, but most commonly the scar is located in the crease at the bottom of the breast, which is easier to hide.