Mastectomy is a procedure that must be performed by a duly certified and experienced plastic surgeon, it should be achieved more than a flat chest: ideally, subcutaneous mastectomy results in a chest that has an aesthetically pleasing male contour, is completely flat and has no wrinkles and has minimal healing. The procedure involves removing most of the breast mass and excess skin. The nipple and halo reserve is sufficient if the nipple-areolar complex has the appropriate size and shape, but often the reduction.
The choice of technique should be appropriate for the size of the chest and the quality of the skin of the patients:
The small breast with good elasticity of the skin should be removed with a minimal incision and scarring. A periureolar model (or U-shaped scar) is frequently used in these cases.
Moderate chest size (cup B) with good elasticity can be removed with a concentric incision that collects the skin and leaves a scar around the areola (O-shaped scar).
Large or pendular breast requires a complete mastectomy (which includes nipple removal) with free grafting of the nipple-areolar complex to a new suitable position. This technique affects sensitivity significantly, but it will be the only option for large or inelastic breasts.
Skin that is inelastic (due to the use of a bandage for the chest) can negatively affect the result and will influence the choice of surgeon techniques.
Risks and complications:
- Hemorrhage: bleeding is a risk of any operation, but the need for transfusion is very unlikely. However, specialist surgeons take this into account and will always control bleeding during the operation.
- Infection: infections are very rare.
- Nipple necrosis: the nipple's blood minister will be damaged by limitations of the operation and the nipples could die. If the nipples are used as a graft, they may not survive. These complications are extremely rare.
- Healing: aureole scars usually heal well. The scar below the chest is longer and wider than the one mentioned above: however, an elevated or excessively wide scar is possible, and more treatment will be needed.