Mastectomy

This procedure removes all of the breast tissue, including the nipple, areola, skin, and the fascia (covering) of the main chest muscle. Depending on your care plan, a few lymph nodes may also be removed through a sentinel lymph node biopsy. 

• In many cases, this can be done in a skin-sparing or nipple-sparing way, which keeps a layer of skin to help with breast reconstruction. 
• Most people go home the same day as surgery, and those who are hospitalized go home the day after surgery

In this procedure, your surgeon removes the entire breast and the lymph nodes under the arm (axillary nodes).  

A modified radical mastectomy includes: 

• A total mastectomy. A surgeon removes the entire breast, including the nipple, areola, and skin. The muscles of your chest wall (beneath the breast) are not removed. 
• An axillary lymph node dissection. A surgeon removes all the lymph nodes in the axilla (underarm). This may involve taking anywhere from 4 to 20 lymph nodes.

This surgical approach preserves as much of the breast skin as possible to support reconstruction. During this procedure: 

• The surgeon removes the breast tissue, the nipple, and the areola  
• The breast tissue is removed through a small opening 
• Most of the outer breast skin is left in place 

This technique: 

• Helps maintain the natural shape and form of the breast 
• Supports immediate reconstruction with implants or your own tissue 
• Is often chosen by people who want the best possible cosmetic result after surgery 
• Can be done as part of either a total (simple) mastectomy or a modified radical mastectomy, depending on your diagnosis and treatment plan

In some cases — including preventive surgery or early-stage cancer — the nipple and areola can be preserved in addition to the skin. 

• The breast tissue is carefully removed from beneath the nipple 
• Keeping the nipple-areolar complex may help improve satisfaction with reconstruction 
• Your surgical team will evaluate whether this option is safe for your specific case

There will be a significant change in the appearance of your chest after mastectomy, even if you choose reconstruction.  

• Differences in symmetry or shape 
• With or without reconstruction, your breasts may not match in size or shape, leading to visible asymmetry. You may also have changes to the nipple’s position after a nipple-sparing surgery. Reconstruction could result in drooping (sagging) or wrinkling (dimpling) of the tissue. Many patients have additional surgeries after reconstruction to fix these differences. 
• Unnatural appearance 
• With or without reconstruction, your breasts may not look or feel the same (or as natural) as they once did. Removal of nipples during surgery contributes to this, as do changes in the size or shape of the breast. 

Yes. The scar will usually be about 10 cm or longer. It can be across the skin of the chest or in the armpit, depending on the extent of tissue removal. The scar will initially be firm, slightly raised, and red, but it will likely flatten and fade over several months to a year.

After a mastectomy, numbness or loss of sensation is common, often in the chest, under the arm or upper arm. While symptoms may improve for some, for others it can become a permanent issue due to nerves being stretched, cut or damaged during surgery, manifesting in the lack of feeling sensation on and across the chest.   

Common effects of mastectomy include: 

• Pain or tenderness near the incision 
• Swelling where your breast was removed 
• Limited movement in your arm or shoulder 
• Lymphedema (buildup of lymph fluid that causes swelling) if your axillary lymph nodes were removed

Your doctor may instruct you not to lift objects heavier than 5 pounds for four to six weeks. You also won’t be able to raise your arm over your head at first, especially when your drains are still in.  

Ask your doctor how long you need to avoid more strenuous activities (like jogging, tennis, or weightlifting) and about exercises and movements you can do while you are healing.

If you have a mastectomy for early-stage cancer, you may not need radiation, but about 40-50% of people still do. Your team may refer you to a radiation oncologist based on the results from your surgery.

The site of mastectomy surgery, and especially mastectomy with reconstruction, needs time to heal before you can wear a breast prosthesis or bra. For a breast prothesis, it may be 6-8 weeks before you are ready to wear it. Time between surgery and wearing a bra varies, though some plastic surgeons and breast surgeons put people in a bra right away. Follow your post-surgical instructions or ask your doctor to let you know how long you need to wait after your mastectomy surgery.