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Nipple Sparing Mastectomy

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Nipple sparing mastectomy with reconstruction consists of the removal of breast tissue but preservation of the patient’s own nipples and areola.  Immediately following breast removal, a plastic surgeon reconstructs the breast by inserting a tissue expander or a permanent breast implant.

In 2013, renowned actress Angelina Jolie revealed to the world that she had undergone bilateral nipple sparing mastectomy surgery  to lower her risk of developing breast cancer.   She had both a strong family history of breast cancer and a mutation of her BRCA1 gene, one of the genes that suppresses the growth of tumor cells.  Angeline learned that the majority of women carrying the BRCA1 mutation are expected to develop breast cancer if they live to the age of 70.

Nipple sparing mastectomy is also a solution for women with severe fibrocystic disease.  These women often complain of breast lumps, pain and tenderness of the breast(s), all of which can be responsive to the patient’s menstrual cycle.

Ever since Angelina’s announcement, nipple sparing mastectomies have become quite popular.  Women are ecstatic with the idea that they can significantly reduce their risk of  breast cancer or rid themselves of severe fibrocystic disease and yet possess reconstructed breasts which contain their own nipples.  However, there are some details which every prospective patient must be aware.

Nipple sparing mastectomies does not completely erase the risk of developing breast cancer.

The nipples might appear perfectly normal but they do not function normally:

  •    they have diminished or no sensation.
  •    they do not become erect when stimulated
  •    of course, they cannot eject milk.

It is more likely than not that revision surgeries will eventually be necessary.

Patient who decide to undergo nipple-sparing mastectomies conclude the benefits of the procedure far outweigh these shortcomings.

Both Doctors Pellegrino and Perrotta are highly skilled at reconstructing breasts following nipple-sparing mastectomies, and they receive great fulfillment serving as integral parts of the regional breast-care team.

before and after patient photos


Candidates for Nipple Sparing Mastectomy (NSM) and Implant Breast Reconstruction

  • women with strong family history of breast cancer
  • women with genetic high risk of breast cancer
  • women with severe, symptomatic fibrocystic disease
  • some women with breast cancer

The Goals of NSM and Implant Breast Reconstruction

  • for women with pre-malignant breast lesions: to lower the risk of breast cancer
  • for some women with specific types and presentations of breast cancer: to remove the breast cancer
  • for women with severe fibrocystic disease: to relieve the breast pain and tenderness

Initial Consultation

Doctor Pellegrino or Doctor Perrotta will evaluate your personal and family history and perform a focused physical exam  to determine if you might be a good candidate for nipple sparing mastectomy.  He will also review any laboratory data that already is available.

If he concludes you would benefit from nipple spring mastectomies, he will discuss the case with a breast (mastectomy) surgeon in whom he has great confidence.

Pre-Op Visit

During this visit, your plastic surgeon will prepare you for surgery.  He will answer all of your questions, provide you additional detailed information about the procedure and perform your pre-operative physical examination.  His assistant will take your pre-op photos.

The Procedure

Nipple sparing mastectomies are performed in tandem with immediate breast reconstruction.   In most cases, a breast surgeon removes the breasts and, while doing so, leaves in place all the skin, including the the nipples and areolas. Immediately thereafter, the plastic surgeon reconstructs the breasts with implants.

Post-Op Recovery

Most patients have significant pain for up to several days and then moderate discomfort for two weeks thereafter.  They can return to work in two to three weeks. Months following the initial surgery, fat grafting can be effective in smoothing the contours of the breasts and/or thickening the skin lying over the implants.

Before and After Photos

Click here to see our NSM and Reconstruction Before and After photo gallery.

We are grateful to our patients for granting us the privilege of posting their before and after photos on our website. While we greatly value their privacy, we also salute their eagerness to share their life-changing results with other individuals considering plastic surgery.  Every patient on this website has enthusiastically provided his or her written consent for us to show the world his or her results. No one is under obligation to do so.


Contact us today to schedule a NSM and Reconstruction consultation.