Nipple Sparing Mastectomy with immediate reconstruction
I had a bilateral nipple sparing mastectomy with immediate reconstruction on December 15, 2009. In my research I did not find a lot of posts about this particular procedure. I wanted to start a forum for women who have had the same surgery, or who are considering this type of procedure. We could share helpful information on pre/post operative concerns or suggestions. So if you have questions or suggestions please feel free to post. I look forward to hearing from you!
Lingo used on thread:
BMX-Bilateral Mastectomy (both boobs)
UMX-Unilateral Mastectomy (one boob)
NSM-Nipple Sparing Mastectomy (saving nipple and skin)
SSM-Skin Sparing Mastectomy (saving the skin, but not the nipple)
TE-Tissue Expander (used to stretch skin and muscles before placing implant)
Mayo clinic explanation of NSM on youtube.com:
NSM & SSM: What to Ask Your Surgeon
Questions for Your General, Breast or Oncologic Surgeon
- Where and when did you receive your general surgery training?
- Are you board certified in general surgery?
If not, why not?
- Are you in good standing with the medical board?
- How many mastectomies do you perform on a yearly basis?
- What type and percentage of types of mastectomies do you perform most?
(types are: lumpectomy, traditional mastectomies, and skin-sparing mastectomies)
- Are you familiar with and do you perform skin-sparing mastectomies?
If not, would you please recommend a general surgeon who is, for a second opinion?
If yes, how many have you performed?
- Is there any reason why I would not be a candidate?
(The main reason would be that breast skin is invaded. Note that skin is not the same as breast tissue! Or if the breast cancer is at an advanced stage. Read inclusion and exclusion section.)
- What will the scars on my breast look like?
- Do you have photos of your mastectomies to show me?
If not, please show me a medical journal photo that resembles your work.
- EXACTLY what skin will be removed?
(If it is most of the breast skin, then it is NOT skin-sparing!)
- EXACTLY where will the scars be located?
(You may want to ask your doctor to DRAW the scars with marker on your body.) With a skin-sparing mastectomy, the marks MUST be drawn in a KEYHOLE pattern, (i.e. under the breast fold, coming up to and around the nipple.) A traditional mastectomy will be one or two long incisions across the front of the breast, leaving little or no breast skin.)
- Who will do the marking for the incision? You or the plastic surgeon?
- Can the plastic or oncoplastic surgeon do the marking?
If not, why not?
- If not reconstructed at the time of mastectomy, then what communication are you, the general surgeon, going to have with the plastic surgeon about the incisions placement before the surgery so you have the best possible cosmetic result?
- Am I a candidate for immediate reconstruction (at the time of mastectomy)?
If not, why not?
- If I have future reconstruction, will the surgery leave my breast skin so I can have a skin-sparing mastectomy?
- What plastic surgeons do you work with?
- Will the plastic surgeon do the pre-surgical marking and determine the location of the incisions?
- Would you be willing to provide me with the name of another general surgeon for a second opinion?
Questions for the Plastic Surgeon
- Ask the questions above, making the appropriate substitutions.