Rebuilding a Breast Without Major Scarring.

• Position: Brief Article

Complete skin-sparing breast surgery offers the possibility of a scarless mastectomy without compromising the fundamental goals of breast cancer care. "This technique has definite advantages for women who are having a mastectomy," suggests David A. Hidalgo, chief of plastic surgery, Memorial Sloane Kettering Cancer Center, New York. "The final cosmetic result is far superior to that of the normal mastectomy. Women facing breast surgery should know that this option is available and ask for it."

The technique involves placing the incision around the edge of the areola (the circular area around the nipple) so that the breast tissue may be removed. Immediate reconstruction using the skin-sparing technique requires autologous tissue--tissue from the patient's own body--to rebuild the breast mound and replace the nipple area. The most commonly utilized procedure involves incisions that go across the breast from one side to the other, leaving obvious scars on the reconstructed breast.

The study reviewed 30 patients, ages 32 to 57, who were diagnosed with cancer or who were having preventative surgery (prophylaxis). Of these, 27 had a transverse rectus abdominis myocutaneous (TRAM) flap procedure that utilizes tissue from the patient's abdomen to...