Delayed nipple-sparing modified subcutaneous mastectomy: Rationale and technique

Beniamino Palmieri, George Baitchev, Simone Grappolini, Alberto Costa, Giorgia Benuzzi

Research output: Contribution to journalArticlepeer-review


The problem of nipple-areola complex (NAC) preservation during mastectomy is a very intriguing and stimulating issue. In fact, in order to perform an oncologically safe operation, no mammary tissue (enclosed in the main galactophoric ducts) should remain; on the other hand, without the blood supply coming from the breast gland, NAC viability is greatly impaired because the surrounding vascular dermal network is not developed enough to support its metabolic requirements. We suggest therefore a two-step surgical procedure. The first step, on an outpatient basis with local tumescent anesthesia, is a mini-invasive cutting and coagulating procedure. It addresses the autonomization of the vascular supply to the NAC by detaching the galactophore stalk from the nipple and coagulating the deep vascular plexus. The second step, under general anesthesia and again with tumescent technique, removes the breast within its capsule, with careful checks of any remnant and adequate approach to the axilla. A subpectoralis prosthesis completes the procedure. In our view, this technique is electively suitable for prophylactic mastectomy, but also for stage I breast cancer, 2.5 cm from the NAC and 1.5 cm from the skin and pectoralis fascia, and it is very safe, simple, and effective.

Original languageEnglish
Pages (from-to)173-178
Number of pages6
JournalBreast Journal
Issue number3
Publication statusPublished - May 2005


  • Delayed nipple-sparing modified subcutaneous mastectomy
  • Mastectomy
  • Nipple-areola complex preservation

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology


Dive into the research topics of 'Delayed nipple-sparing modified subcutaneous mastectomy: Rationale and technique'. Together they form a unique fingerprint.

Cite this