Mastectomies can be life-saving procedures. Most women have this type of surgery to remove existing cancer from the breast tissue. However, a doctor may also recommend a mastectomy for women with a high risk of developing cancer due to genetics or other factors. Knowing your options can help you make an informed decision about surgery and post-op prosthetics. 

What Are the Different Types of Mastectomies?

1. Simple Mastectomy 

Also known as a traditional or total mastectomy, this procedure involves removing the entire breast. Usually, this includes the tissue, as well as the skin, nipple, and areola. The doctor will not remove any muscles beneath the breast. 

The doctor usually does not remove the lymph nodes in the armpit in this procedure. However, they may need to do so if the patient has invasive breast cancer. This allows the doctor to examine the structures and see if the cancer cells have spread beyond the breast. A procedure in which the lymph nodes are removed may be referred to as a modified radical mastectomy. 

Women may need this operation if they have multiple or large areas of ductal carcinoma in situ (DCIS). Women who have a genetic predisposition to breast cancer or who have had breast cancer once may wish to have a prophylactic, or preventative, simple mastectomy. These procedures eliminate all possibility of the patient developing breast cancer.

2. Skin-Sparing Mastectomy 

A surgeon may perform a skin-sparing mastectomy as a simple or radical mastectomy. The key distinction is that this type of procedure involves removing only the breast tissue, nipple, and areola while preserving the breast skin. Typically, the surgeon removes the tissue through the incision in the nipple area. For women with very large breasts, however, an additional incision may be necessary. 

A surgeon can reconstruct the breast immediately, in many cases, using an implant or tissue from another part of the body. The main advantage of this surgery is it can provide a more natural-looking reconstructed breast.

However, it may not be an option for particularly large tumors or those that are close to the surface. Another potential risk is that because the skin envelope is very thin, the blood supply may decrease, leading to wound breakdown and skin loss. 

3. Nipple-Sparing Mastectomy 

This procedure involves removing all of the breast tissue while leaving the skin, nipple, and areola intact. Also known as a subcutaneous mastectomy, it involves making an incision in the fold of the breast. Here, the scar will not be as visible once the incision has healed. Alternatively, a surgeon may make an incision around the areola and extract the tissue from there. 

In this case, there is no need to reconstruct the nipple, which can contribute to a more natural-looking reconstruction.

This may not be an option for everyone, depending on the cancer location. If cancerous tissue is found in the nipple, it must be removed. 

4. Bilateral Mastectomy 

Women who have not been diagnosed with cancer but are at a high risk of developing it may undergo a preventative bilateral mastectomy. Usually, women with the BRCA (Breast cancer type 1 or type 2 susceptibility protein) gene mutation, which is prevalent in individuals with breast cancer, are those who opt to have both breasts removed.

Most bilateral surgeries are simple mastectomies, but some are nipple-sparing. Previously called a prophylactic mastectomy, this involves removing most of the breast tissue, but not all. If a woman develops breast cancer in that tissue later, she may have to undergo another surgery. 

What Is the Recovery Process?

The recovery process varies depending on the type of procedure and other factors. Immediately after surgery, however, most patients are taken to the post-anesthesia care unit. Here, the hospital staff will monitor them while the anesthesia wears off. Then, the patient will relocate to a hospital room for monitoring for 34 to 48 hours. 

In the first few days, patients may experience some pain and will need to rest. Doctors usually ask patients to abstain from activities that involve a bouncing motion, as this may cause pain.

Patients should also abstain from lifting or anything strenuous, as it may strain the incision and cause pain. Many patients can return to life as usual, including partaking in vigorous physical activity such as running or going to the gym, after six to eight weeks. 

Many patients also undergo radiation therapy, chemotherapy, or both along with their mastectomy. These treatments will also factor in the recovery process. Your doctor can help you understand your options and what to expect. 

What Are the Different Types of Mastectomy Implants & Bras?

There is a range of options available for short-term and permanent wear. This includes post-surgical garments, which can promote comfort and safety post-surgery. 

Bras are also available. These have pockets to hold breast prosthesis but otherwise appear similar to other bras. They are available in a range of colors and styles. There are everyday options, as well as activewear and swimwear. 

Breast prostheses are artificial breasts designed to resemble natural breast tissue. You can attach these to your chest with a special adhesive or place them in a mastectomy bra.

In addition to simulating a natural breast aesthetically, prostheses can be beneficial as they can balance the weight distribution that may be slightly off after having a single breast removed. This can promote comfort and reduce issues, such as back or knee pain that may occur from imbalanced weight distribution. 

 

If your doctor has recommended a mastectomy to remove cancerous tissue or reduce your risk of developing the disease, consider looking into reconstructive possibilities once you have chosen a mastectomy option. In Cold Spring, KY, National Prosthetics & Orthotics provides a range of breast prosthesis options, including implants and bras. Call (859) 442-0400 to speak with a caring team member about how they can help you. Visit the website to learn more about the practice and what they have to offer.