Nipple-sparing mastectomy

In a nipple-sparing mastectomy, the surgeon removes all the breast tissue but keeps the nipple and areola. Sometimes they do a skin-sparing and nipple-sparing mastectomy. 

Nipple-sparing mastectomy is not possible for everyone. This procedure may be suitable if you do not have breast cancer close to the skin or nipple and you are having:

• reconstruction at the same time as mastectomy surgery (‘immediate reconstruction’)
• breast reconstruction later (‘delayed reconstruction’). Usually you have a skin expander inserted during the mastectomy surgery. 

For people with DCIS, this is usually only done as part of immediate reconstruction.

If keeping your nipple is important to you, ask if nipple-sparing mastectomy is a safe option.

About the procedure

The surgeon makes a cut underneath the breast or on the outer side of the breast.

When they remove the breast tissue, this creates a space in the breast. A temporary expander or an implant fills the space.

Risks of nipple-sparing surgery

The major risks are:

• the nipple and surrounding skin need enough blood supply, or the tissue may die. Up to 10 per cent of these surgeries have some complications that can affect the result
• you may lose feeling in the nipple.

Alternatives to nipple-sparing surgery

Your surgeon or breast care nurse can talk to you about the other options. You may choose nipple reconstruction surgery after the mastectomy and breast reconstruction.

Or, instead of surgery, you might choose to:

• have a nipple tattoo that looks 3D, to create the permanent look of a nipple
• have a decorative tattoo where the nipple was
• wear a temporary adhesive nipple – a prosthesis you can wear some or all of the time.

Read about the options for Nipple tattoos and adhesive nipples. Talk to your surgeon or breast care nurse about the options and services available.