Mastectomy Skin Necrosis: Risk Factors, Prevention, and Management

In the past decade, there has been an increasing focus on both therapeutic and prophylactic mastectomies in the management of breast disease. It has also become the standard of care to offer patients breast reconstruction for appropriate candidates after mastectomy, which often leads to a multidisciplinary partnership between the oncologic surgeon and the reconstructive plastic surgeon. In most clinical settings, the oncologic surgeon will perform the extirpation of the breast tissue and the reconstructive surgeon will subsequently restore the shape and contour of the native breast through either tissue expander-implant based reconstruction or by autologous tissue transfer. The advent of the skin-sparing mastectomy by the oncologic surgeon has increased the aesthetic potential for reconstructive surgeons by increasing the amount of native skin available for the reconstruction, and therefore offers the most cosmetically appealing reconstruction possible for patients undergoing both unilateral and bilateral mastectomies.