How Nipple-Sparing Mastectomy Can Boost Self Esteem and Preserve Natural Appearance

By Priya Bhakta, MD, Breast Surgery

For many women, a breast cancer diagnosis brings not only fear of the disease itself but also anxiety about the physical and emotional aftermath of treatment. The idea of losing a breast, or both, can feel like losing a part of one’s identity. Today, surgical innovation is changing that narrative. 

One of the most promising developments is the nipple-sparing mastectomy (NSM), a procedure that removes cancerous tissue while preserving the skin and nipple. This approach offers a powerful combination of cancer control, aesthetic preservation, and emotional healing.

What makes nipple-sparing mastectomy different?

Traditional mastectomy removes the entire breast, including the nipple and surrounding skin. While effective, this method often leaves behind scars and a flatter chest wall, which can be emotionally distressing for many patients.

Nipple-sparing mastectomy, by contrast, removes the breast tissue, leaving the nipple-areola area and most of the skin intact. This allows for immediate reconstruction that closely resembles the natural breast. The result is not just a more familiar appearance, but also a smoother psychological transition after surgery.

Many women who undergo NSM have higher satisfaction with their body image, greater confidence, and a stronger sense of continuity with their pre-surgery selves.

"For patients interested in reconstruction, we have the option of saving the skin and, depending on the location of the tumor, even the nipple. This technique allows for a more natural post-reconstruction appearance, which is a significant concern for many patients," says Priya Bhakta, MD, a breast surgical oncologist at Loyola Medicine. 

Who is a good candidate for nipple-sparing mastectomy?

Nipple-sparing mastectomy is not suitable for everyone, but eligibility has expanded significantly in recent years. nitially reserved for women with small, early-stage tumors located far from the nipple, the procedure is now being offered to a broader group, including some patients with more advanced disease or those undergoing risk reducing mastectomy due to genetic predisposition like BRCA mutations.

Surgeons assess eligibility based on several factors, including:

• Tumor size and location: The cancer must not involve the nipple or the surrounding skin.
• Breast shape and size: Smaller breasts with minimal sagging are typically more suitable.
• Smoking history and prior radiation: These can affect healing and increase the risk of complications like nipple necrosis.

Surgeons often remove tissue directly beneath the nipple and send it for immediate pathology testing. If cancer cells are found, the nipple may still need to be removed. NSM has been shown to have recurrence rates comparable to a traditional mastectomy. 

“Each patient’s case is unique. We take into account tumor size, location, and the patient’s personal preferences when deciding whether to preserve the nipple and how much skin to save. Our goal is to not only remove the cancer but to help the patient feel whole again," says Dr. Bhakta.

What recovery from NSM looks like

Most patients go home within a day and return to light activities within a few weeks. Full recovery, including reconstruction, takes several weeks. While sensation to the nipple is typically lost, the preservation of the nipple structure itself can still provide a significant emotional benefit.

Making an informed decision about nipple-sparing mastectomy

Choosing a surgical approach to breast cancer treatment is deeply personal. It’s not just about removing cancer; it’s about how you want to feel in your body afterward. That’s why it’s essential to work with a care team that takes the time to understand your goals, values, and concerns.

At Loyola Medicine, patients benefit from a multidisciplinary team that includes breast surgeons, oncologists, plastic surgeons, and radiation specialists. Together, we create a personalized plan that balances medical safety with emotional well-being.

“We’re actively involved in clinical trials, ensuring that our patients have access to the latest advancements in breast cancer treatment," says Dr. Bhakta. This access to new therapies and protocols allows Loyola to offer treatments that may not be available at other centers. 

If you’re facing a breast cancer diagnosis or considering preventive surgery, ask your doctor whether nipple-sparing, minimally invasive surgery is an option for you.

Priya Bhakta, MD, is a breast surgical oncologist and board-certified general surgeon at Loyola Medicine, specializing in breast surgery and minimally invasive surgical techniques. She is committed to providing compassionate, patient-centered care with a focus on advanced surgical options for breast cancer treatment, including nipple-sparing and skin-sparing mastectomies.