For many people, a mastectomy raises questions about how their chest will look and feel afterward. A skin-sparing mastectomy removes breast tissue but keeps as much healthy breast skin as possible, which can help create a more natural shape during reconstruction.

“I only had cancer in one breast, but had a double mastectomy with skin-saving, including nipple, procedure on both. Looks just like how it was before,” a member of MyBCTeam shared. “What can be more natural than your natural parts?”

A skin-sparing mastectomy usually combines breast reconstruction with a mastectomy in one surgery. A breast surgeon will typically work with a plastic surgeon who performs the reconstruction after the mastectomy.

“I ... had a double mastectomy with skin-saving, including nipple, procedure on both. Looks just like how it was before. What can be more natural than your natural parts?”

— A MyBCTeam member

Here’s what you need to know about skin-sparing mastectomy, including the techniques used, what recovery is like, and possible complications.

Delayed-Immediate Reconstruction With Skin-Sparing Mastectomy

In some cases, when radiation therapy is needed, a skin-sparing mastectomy may be appropriate for those who plan to have reconstruction later, in a separate surgery after their mastectomy has healed.

In delayed-immediate reconstruction, another type of reconstruction that’s done with skin-sparing mastectomy, a surgeon will place a temporary expander under the chest wall muscle to create space for the reconstructed breast.

Delayed-immediate reconstruction with a skin-sparing mastectomy helps preserve the breast skin for later reconstruction. This approach may lower the risk of complications if reconstruction is done later.

Recovery From Skin-Sparing Mastectomy

Recovery from a skin-sparing mastectomy is different for everyone, but most people go through similar stages. Your healthcare team will give you instructions to support healing and recovery. Be sure to attend your follow-up appointments and follow your doctor’s guidance.

Skin-sparing mastectomy is usually performed as an outpatient procedure, where you go home the same day, or with a hospital stay of one night. Here’s a breakdown of what you can expect with a typical recovery from a skin-sparing mastectomy in the weeks after surgery.

Recovery time is generally quicker with a skin-sparing mastectomy and immediate breast reconstruction.

“I had a skin-saving mastectomy over a year ago. My nipples couldn’t be spared because of a tumor, but I didn’t find the surgery bad at all,” wrote one MyBCTeam member.

“I had a skin-saving mastectomy over a year ago. My nipples couldn’t be spared because of a tumor, but I didn’t find the surgery bad at all.”

— A MyBCTeam member

The First 2 Weeks After Surgery

You can expect some tenderness and swelling in the first week of recovery. You’ll have pain medication to manage discomfort from the surgery. If you also had reconstructive surgery with your skin-sparing mastectomy or a temporary expander placed, your chest may feel tight.

As your body recovers from surgery, fatigue is common. Your doctor will explain how to care for your wound at home and which activities to avoid. You may have one or more surgical drains to help prevent fluid buildup near the wound.

By Week 2, you’ll likely feel better, but still feel tired. You can resume some light activity, but make sure to follow your doctor’s advice on lifting, reaching, and other physical movement.

Throughout the first two weeks of recovery, your surgical care team may recommend slow, short walks or other gentle types of physical activity to help with blood circulation. This can help with healing.

If you’ve been given a tissue expander, your surgeon will need to inflate it every two or three weeks with a saltwater solution. This will cause tightness in your chest for a few hours.

“My surgery was skin-saving, and my nipples have been removed,” said a MyBCTeam member. “I currently have expanders in place and haven’t yet received my first saline injections.”

If you’ve had breast reconstruction using your own tissue, you’ll probably have another surgical site where tissue was taken, in addition to your skin-sparing mastectomy. This can cause more pain and discomfort.

Recovery Weeks 3 and 4

You should start feeling more like yourself with more energy and mobility in the third and fourth weeks after surgery. There may still be some swelling, but the drains will likely be removed by this time. You’ll be given instructions on how to care for your surgical scar tissue.

If you’ve had breast reconstruction with a skin-sparing mastectomy, your surgeon may advise you to do some easy exercises to improve range of motion. Around four weeks after surgery, many doctors recommend physical therapy to help you with exercises that can relieve muscle tension and help you heal with good muscle function.

Week 5 and Beyond

Your energy and strength will continue to improve, and you’ll be able to do many of your normal activities. Most physical restrictions will ease up. Still, it’s important to follow your surgeon’s instructions. Your body will continue to heal internally for a few months.

Potential Complications of Skin-Sparing Mastectomy

All types of mastectomy can have complications. Before a skin-sparing mastectomy, ask your surgical team what to watch for and when to call your doctor.

Some factors increase the risk of complications, including:

• Smoking
• Radiation therapy for your breast cancer
• Diabetes
• Higher body weight
• High blood pressure

Here are some of the possible complications that are associated with a skin-sparing mastectomy.

Infection

A little more than 5 percent of women who have breast cancer surgery develop an infection. Your surgical team will take steps to lower this risk. If you have breast reconstruction with an implant, an infection can develop days or weeks after surgery.

Signs of infection include fever, chills, increased discoloration or swelling, more drainage, pus, bruising, and an unusual odor. Contact your doctor right away if you think you may have an infection.

Hematoma

A hematoma is a pooling of clotted blood that can develop in breast tissue after surgery. Symptoms include discoloration similar to bruising, a soft lump or swelling, and pain in the breast.

Hematomas are usually harmless and go away on their own. Tell your doctor if a hematoma keeps getting darker, bigger, or worse.

Skin Necrosis

Skin necrosis happens when damage to blood vessels cuts off blood flow to the breast skin, causing skin cells to die. In breast cancer surgeries when the skin stays attached, as in a skin-sparing mastectomy, necrosis is less likely to happen.

Signs of skin necrosis include dark discoloration, open wounds, blisters, scabs, swelling, and tenderness.

Postmastectomy Pain Syndrome

Between 20 percent and 60 percent of people who have breast cancer surgery develop postmastectomy pain syndrome (PMPS), a type of nerve pain. With PMPS, there is pain in the chest, inner arm, and armpit, which can be mild or severe.

PMPS can be treated. Talk to your doctor if you’re having ongoing pain or sensitivity.

Talk to Your Doctor

It’s normal to have a lot of questions and anxiety when planning a mastectomy for breast cancer. Communicating openly with your doctor about your concerns about recovery and what to expect with breast reconstruction can help ease your worries.

Your healthcare team understands that preparing for a mastectomy can bring up a range of emotions. They can help support you and give you a clearer idea of what to expect. You may want to bring a loved one to your surgery appointments for support.

Join the Conversation

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

Have you had a skin-sparing mastectomy? Let others know in the comments below.