Is it common to leave aerolas but not nipples during prophylactic BMX? Can it be done?

I'm an American living in Switzerland. Was diagnosed with LCIS this past summer. I have a Very strong history of Bc as well as having had chest radiation 30+ years ago due to Hodgkins. I met with a ps here in Switzerland last week and he proposed leaving areoles but taking nipples. Additionally, he can do the whole thing. I know this is not the norm in the States so I'm a little nervous about this. He is supposed to be one of the best as he began pioneering the DIEP flap in Europe.

Doctor Answers 3

Breast Reconstruction - Areola-Sparing Mastectomy

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Yes, I occasionally recommend areola-sparing mastectomy. A patient with very strong propensity to develop breast cancer, removing the nipples, removes additional risk. The skin from the DIEP flap can be used to reconstruct the nipple with in your native areola. Some plastic surgeons are also trained in general surgery and can perform the the prophylactic mastectomy so it's reasonable if they don't have access to a good breast surgeon.

Best Regards,

Areola sparing mastectomy

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One can spare the areola at the time of the mastectomy without taking the nipples.  It would be important to be sure they are positioned in the proper position on your chest wall at the time of surgery.  Your history of radiation, can result in delayed healing due to compromised blood supply to the radiated tissue.
In the US, a breast surgeon or general surgeon confident in mastectomy procedures performs the procedure in  conjunction with a plastic surgeon.  This may not be the case in Switzerland and totally the norm.  I recommend that you address your concerns with your surgeon and ask about his complication rates if that would to alleviate some of your concerns.

Skin Sparing Mastectomy

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It is possible to design the skin sparing mastectomy so as to remove the nipple and leave the areola (Pigmented skin). The areola has no connection to the gland.

Previous radiation to the chest will be of concern to wound healing and the quality of skin for the method of breast reconstruction. All this plan should be coordinated with the oncologist and the radiation therapist, with input for future need of both specialties.
Oncologic surgeon to do the mastectomy, plastic surgeon input into the design of the scar, plastic surgeon to do the immediate breast reconstruction.

Samir Shureih, MD
Baltimore Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.