Mastectomy and Immediate Single-Staged Skin-Sparing Breast Reconstruction

A Breast Cancer diagnosis is devastating and the idea of a mastectomy is often just as difficult to accept. While your primary goal is to rid your body of cancer, it can be hard to imagine ever getting back to feeling “whole” again. Part of a complete recovery is restoring confidence in how you look and feel.

Dr. Joseph Rucker performs the new skin-sparing, single-stage mastectomy and immediate reconstruction which preserves, in some cases, the nipple and areola as well as the breast skin. 

The benefits of this technique are:

• One surgical procedure for both the mastectomy and reconstruction.
• One recovery.
• Patient's skin envelope is preserved.
• Usually only one overnight hospital stay required.
• No increased risk of recurrence.
• Better cosmetic result after reconstruction.

The Procedure: On the surface, your natural breasts are preserved. Inside, your tissue is completely replaced with an implant. This state of the art procedure involves the cooperation of a cancer surgeon and Dr. Rucker acting as a team, along with your oncologist. 

Until now, mastectomies involved flaps, expanders, tattoos and scars. Skin and nipple-sparing mastectomy offers an option that is less severe and more cosmetic. By retaining the shell of your natural breasts and using an implant, the results often resemble a breast augmentation rather than a reconstruction.

Insurance Coverage: Single or double mastectomy? A federal law was passed in 1998 requiring all health insurance companies to cover reconstruction of the breast on which mastectomy has been performed. Additionally, it covers surgery and reconstruction of the other breast to produce a symmetrical appearance.  Because of this, women with a higher risk of developing breast cancer, and who formerly might have considered a single mastectomy now elect to have both breasts removed and reconstructed.

Risk of Recurrence: Skin-sparing mastectomy has been advocated as an oncologically safe approach for the management of patients with early-stage breast cancer that minimizes deformity and improves cosmesis through preservation of the skin envelope of the breast. Extensive research has been done regarding this procedure when compared with mastectomies that remove all the tissue, skin and nipples. The result? The new skin and nipple-sparing mastectomy in no way contributes to recurrence. In addition, careful review of scientific research over 20 years found no proven link between breast implants and auto immune or other systemic diseases, nor do they inhibit future cancer detection.

Candidates for Procedure: Many, but not all, patients are candidates for a skin-sparing mastectomy. Your choices may be limited by your pathology or prior surgeries. However, this new option has made women with the BRAC gene and those at high risk for breast cancer consider a skin and nipple-sparing mastectomy prophylactically - removing the tissue as a potential target. Others considering lumpectomy, which can be disfiguring, can now confidently opt for removal of all tissue while preserving and enhancing their natural breasts. These patients leave the hospital not only with their shape and contour intact, but the gift of peace of mind, knowing that all of the breast tissue has been removed.

Philosophy: Dr. Joseph Rucker, a board certified plastic surgeon with advanced training in breast reconstruction techniques, approaches reconstruction no differently than an elective cosmetic procedure. His keen aesthetic sense makes his goal to leave every woman looking even better than before their unfortunate diagnosis. Working closely with a cancer surgeon and your oncologist, Dr. Rucker will help determine if you are a candidate, considering your individual treatment plan and overall health.  

To view a short video on this subject go to: http://www.youtube.com/watch?v=zUXv2RWny6A.

40 year old female with advanced premalignant breast disease and also with a strong family history for Breast Cancer. She requested bilateral mastectomies and immediate single-stage bilateral breast reconstruction.

1 month after bilateral skin and nipple-sparing mastectomies and immediate reconstruction.