What is Periareolar Mastectomy?
Periareolar mastectomy is a surgical procedure primarily used in the context of gender-affirming surgery for transgender men and for patients needing a mastectomy for medical reasons such as breast cancer. The procedure involves removing breast tissue through an incision made around the areola, the pigmented area surrounding the nipple, which helps to minimize visible scarring.
When is Periareolar Mastectomy Indicated?
This type of mastectomy is typically indicated for patients with smaller breasts and minimal skin excess. It is often chosen by individuals undergoing gender confirmation surgery because it offers a better cosmetic outcome. It may also be suitable for patients with early-stage breast cancer or those with a high risk of developing breast cancer and opting for a prophylactic mastectomy.
Reduced scarring compared to other mastectomy techniques
Preservation of the nipple-areola complex
Enhanced aesthetic results, which is particularly important for gender-affirming surgery
Additionally, for patients with breast cancer, this procedure can provide effective removal of cancerous tissue while maintaining a more natural appearance.
Infection Bleeding
Changes in nipple sensation
Necrosis of the nipple-areola complex
Unsatisfactory cosmetic outcome
Patients should have a thorough discussion with their
gynecologist and surgical team to understand these risks and how they can be managed.
Medical evaluation and clearance, including blood tests and imaging studies
Discussion of the patient's medical history and any current medications
Smoking cessation, as smoking can impair wound healing
Preoperative planning with the surgical team to discuss the desired outcomes and any concerns
Wearing a compression garment to support the chest and minimize swelling
Taking prescribed pain medications and antibiotics to manage pain and prevent infection
Limited physical activity for several weeks to avoid straining the surgical site
Follow-up appointments with the surgeon to monitor healing and address any complications
Patients can typically return to normal activities within 4-6 weeks, although this can vary based on individual healing rates.
Is Periareolar Mastectomy Covered by Insurance?
Insurance coverage for periareolar mastectomy can vary. For patients undergoing the surgery for cancer treatment or prophylaxis, it is often covered by health insurance plans. For those seeking the procedure as part of gender-confirming surgery, coverage depends on the insurance policy and may require additional documentation or appeals.
Conclusion
Periareolar mastectomy is a specialized surgical option that offers significant benefits, particularly for individuals seeking gender-affirming surgery or those with small breasts requiring mastectomy for medical reasons. While it has its risks, careful preparation, and expert surgical care can lead to favorable outcomes. Patients should work closely with their healthcare providers to ensure the best possible results.
