Nipple Sparing Mastectomy: What is NSM? CAUTION

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What is Nipple Sparing Mastectomy (NSM)?

In a nutshell, NSM is a highly specialized breast cancer procedure that preserves the outer shell of the breast, including areola and nipple, in a mastectomy. In one surgery, the breast tissue is removed ("scooped out" if you will), leaving the empty shell, and a silicone/saline implant or body tissue is then inserted into the remaining cavity during the mastectomy surgery. The woman comes out of the surgery with "breasts" fully intact, looking very much like her original self. This procedure can be summarized as "One and Done".

There are several criteria that must be met before a woman can be considered a candidate, such as the size and location of the tumor.

There are many websites that do a wonderful job explaining this in great detail, including some of the risks and concerns associated with this surgery.

This delicate procedure is not performed at every hospital and shouldn't be. It needs to be completed by a qualified breast specialist.

I will include a link for more detailed information.

CAUTION - The following link is VERY GRAPHIC, but an excellent presentation! Photos of NSM are included.

Link to USF/Moffitt/Tampa Bay Breast Care Presentation

What is Skin Sparing Mastectomy?

A skin sparing mastectomy is one in which the breast tissue is removed (scooped out), and the nipple and, sometimes, areola are removed, but the remaining skin is left intact. An expander or implant are put in place during the surgery. If the patient wants a nipple, it can be added later, as a separate procedure, and a tattoo can simulate the areola later, if desired.

What is a Traditional Mastectomy?

A traditional mastectomy is one in which as much tissue as possible is removed, including all the breast tissue, along with the nipple, areola, and most of the skin. The woman comes out of the surgery with a flat surface where the breast had been. If a woman wants reconstruction (the breast built back up again later), an expander (like a balloon) is put in place during the initial surgery. Once the incision and skin heal, the expander is gradually inflated, stretching the skin out over time. When the expander is expanded to the desired breast size of the woman, another surgery exchanges the expander with a silicone or saline implant, typically. Nipple and areola can then be added later, if desired.

Some women opt not to have reconstruction and live with the flat surface created by the mastectomy.