NIPPLE-SPARING MASTECTOMY (N.S.M.) AND IMMEDIATE RECONSTRUCTION
Written by Orlando Florida Plastic Surgeon, Orlando Cicilioni  JR, M.D., F.A.C.S.

Nipple-sparing Mastectomy and immediate reconstruction is becoming increasingly popular in the Central Florida community, and the cosmetic results are becoming more and more aesthetically pleasing. In many cases, the postoperative appearance looks as good as if not better than the previous natural breast! Dr. Cicilioni works with several breast cancer surgeons at the Florida Hospital Cancer Institute to perform immediate reconstruction in conjunction with Nipple-Sparing Mastectomy.

Previously, N.S.M. was only offered to patients with benign disease undergoing prophylactic mastectomy. However, in recent years it has become more common even in cases of D.C.I.S. (in-situ disease) and invasive carcinoma when certain circumstances are met. Generally accepted guidelines usually require the following conditions be met: if an In-Situ or Inavasive cancer is present the tumor should be<3cm in size and at least 2cm from the Nipple Areolar Complex, the regional lymph nodes should be clinically negative, there should be no signs of distant metastatic disease, the breast volume should be of 500grams or less, the retro-areolar biopsy should be negative, and the pre-existing breast shape should not have advanced/third degree mammary ptosis.

Though the safety of N.S.M. remains controversial in patients with a genetic predisposition towards breast cancer, recent literature suggests that N.S.M. may be safe even in situations such as BRCA I/II gene positive states, so long as the patient has close surveillance. Other options may include Areolar-Sparing Mastectomy, wherein the Nipple is removed en-block with the mastectomy specimen, sparing the Areolar Complex.

Please see our Before and After examples of photos of patients who have undergone Nipple-Sparing Mastectomy and Immediate Breast Reconstruction, and if you would like a consultation to discuss N.S.M and Immediate Reconstruction, please contact our office manager, Renee Mason, at Ph (407) 681-3223 to co-ordinate your referrals.