Mastectomy Surgery
Mastectomy is a surgical procedure performed to remove breast tissue as part of breast cancer treatment or, in some cases, risk-reducing surgery for patients at increased genetic or familial risk of breast cancer.
Modern mastectomy techniques focus not only on cancer treatment and surgical safety, but also on preserving breast contour, skin quality, and reconstructive options wherever appropriate. Surgical planning is highly individualised and carefully tailored to each patient’s diagnosis, anatomy, cancer treatment requirements, and personal preferences.
A/Prof Farid Meybodi provides comprehensive, patient-centred breast cancer surgery with a focus on oncological safety, thoughtful surgical planning, aesthetics, and multidisciplinary care.
When Is a Mastectomy Recommended?
A mastectomy may be recommended for:
- breast cancer involving multiple areas of the breast
- large cancers relative to breast size
- recurrent breast cancer
- inflammatory or genetically high-risk breast conditions
- patients choosing mastectomy instead of breast-conserving surgery
- risk-reducing surgery in selected high-risk patients
The most appropriate surgical approach depends on tumour characteristics, imaging findings, breast anatomy, genetic risk, and reconstruction goals.
Simple (Total) Mastectomy
A simple mastectomy involves removal of the breast tissue, nipple, and areola without removing underlying chest muscles.
This approach may be recommended in selected patients with breast cancer or for preventative surgery in higher-risk individuals. Depending on the patient’s circumstances, reconstruction may be performed immediately or at a later stage.
Some patients may also undergo sentinel lymph node biopsy or axillary surgery at the same time where appropriate.
Skin-Sparing Mastectomy
Skin-sparing mastectomy removes the breast tissue while preserving most of the natural breast skin envelope. The nipple and areola are generally removed when involvement by cancer is suspected or confirmed.
Preserving the breast skin can help optimise breast reconstruction outcomes by maintaining the natural breast contour and allowing improved aesthetic reconstruction.
Skin-sparing mastectomy is commonly combined with immediate reconstruction and may be suitable for many patients undergoing breast cancer surgery or risk-reducing procedures.
Nipple-Sparing Mastectomy
Nipple-sparing mastectomy removes the underlying breast tissue while preserving the nipple, areola, and surrounding breast skin.
This technique may offer excellent cosmetic outcomes when combined with immediate reconstruction and is carefully considered in selected patients where cancer is not located close to or involving the nipple.
Careful patient selection, imaging assessment, and surgical planning are essential to ensure both oncological safety and reconstructive success.
Goldilocks Mastectomy
Goldilocks mastectomy is a reconstructive technique that uses the patient’s remaining breast skin and tissue to create a smaller natural breast contour following mastectomy without relying entirely on implants or complex flap reconstruction.
This approach may be considered in selected patients, particularly:
- women with larger or heavier breasts
- patients preferring to avoid implants
- patients who may not be suitable for more extensive reconstruction
- patients seeking a simpler reconstructive option
In some cases, Goldilocks mastectomy may later be combined with fat grafting or delayed reconstruction procedures to further refine breast shape and volume.
Mastectomy & Breast Reconstruction
Many women undergoing mastectomy may also consider breast reconstruction. Reconstruction options may include:
- Implant-based reconstruction
- Autologous (tissue-based) reconstruction
- Fat grafting or lipofilling
- Staged reconstructive procedures
- Symmetrisation procedures
Some patients choose immediate reconstruction performed during the same operation as mastectomy, while others may prefer delayed reconstruction after completing cancer treatment.
Reconstruction planning is highly individualised and coordinated carefully within the broader multidisciplinary treatment plan.
Lymph Node Surgery
Some patients undergoing mastectomy may also require evaluation of the lymph nodes under the arm (axilla).
This may involve:
- sentinel lymph node biopsy
- targeted axillary dissection
- axillary lymph node dissection in selected cases
The extent of axillary surgery depends on imaging, biopsy findings, cancer stage, and response to treatment.
Recovery After Mastectomy
Recovery varies depending on the type of surgery and whether reconstruction is performed at the same time.
Patients may experience:
- swelling and bruising
- temporary discomfort or tightness
- fatigue during early recovery
- changes in breast or nipple sensation
- limited upper body movement initially
Detailed post-operative guidance is provided regarding wound care, drains, activity restrictions, physiotherapy, and follow-up care.
Multidisciplinary Breast Cancer Care
Mastectomy surgery forms part of a coordinated multidisciplinary breast cancer treatment pathway involving:
- breast surgeons
- reconstructive surgeons
- breast radiologists
- medical oncologists
- radiation oncologists
- physiotherapists and lymphoedema specialists
- breast care nurses and allied health professionals
This collaborative approach helps ensure personalised, evidence-based care focused on both cancer outcomes and long-term wellbeing.
Compassionate, Personalised Care
A/Prof Farid Meybodi understands that the decision to undergo mastectomy can feel physically and emotionally overwhelming.
Our goal is to provide compassionate, thoughtful care with clear communication, personalised surgical planning, and coordinated multidisciplinary support throughout every stage of treatment, reconstruction, recovery, and survivorship.
