Immediate bilateral nipple-sparing mastectomy and implant-based breast reconstruction

Total skin-sparing mastectomy (TSSM), which preserves the nipple-areolar complex (NAC), results in better cosmesis when compared with standard skin-sparing mastectomy (SSM) and avoids the need for later NAC reconstruction. Although SSM is well-established as an oncologically safe procedure, nipple-sparing mastectomy is still avoided in many centers due to oncological concerns and the lack of long-term tumour recurrence data. Of the studies to date that have reported 5-year oncological data for the technique, however, the locoregional recurrence is less than 1% per year (1), which is acceptable when compared to simple modified radical mastectomy.