Dr. Rancati will evaluate your medical status and history during your consultation to determine which surgical method will be your best option.
Unless there is a specific cancer-related reason to remove the nipple and areola, most women choose a nipple-sparing mastectomy in which the mastectomy surgeon removes the entire contents of the breast through an incision in the natural fold under the breast.
This surgical technique preserves all of the breast skin, the nipple, and the areolar complex so the implant can be placed immediately. This eliminates the need for tissue expansion and a second reconstructive procedure to create a new nipple-areolar complex.
In preparing for breast reconstruction surgery, you may be asked to:
- Get lab testing or additional medical evaluation
- Take certain medications
- Adjust your current medications
- Stop smoking
- Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements that increase the risk of bleeding
Immediate breast reconstruction surgery is generally performed in a hospital setting using general anesthesia and may include a short hospital stay. However, Dr. Rancati may perform follow-up procedures on an outpatient basis, and local anesthesia with sedation may be used instead.
Once the mastectomy is complete, the reconstruction will be performed immediately. Dr. Rancati uses a permanent implant that he can adjust after the operation filled with saline inside a silicone shell; silicone breast implants are not generally used for immediate breast reconstruction.
The implant is placed over the chest muscle and filled about three-quarters of the way with sterile saline. By partially filling the implant, the skin heals smoothly without tension and reduces the chance of complications. The implant connects to a port under the skin, allowing it to fill with more saline at The Ariel Center following the procedure. For the most part, just one or two inflations are needed to achieve a uniform appearance, after which the port is removed.