Definition - A mastectomy is the surgical removal of the entire breast, usually performed to treat breast disease - such as breast cancer.


Mastectomy – The Four Types:


  • Subcutaneous mastectomy – involves removal of the entire breast except the nipple and areola – which remain in place.

  • Total mastectomy – removal of the whole breast – except for the lymph nodes under the arm (axillary nodes).

  • Modified radical mastectomy – is removal of the whole breast and most of the lymph nodes under the arm (axillary dissection).

  • Radical mastectomy – involves removal of the chest wall muscles (pectorals) in addition to the breast and axillary lymph nodes.  This was the norm for many years, however today it is rarely done.


The reconstruction surgery technique used is determined by the type of mastectomy that was performed. Dr. Lettieri performs the reconstruction surgery in 2 stages:


  1. Tissue expanders inserted after tissue removal

  2. Expanders are later replaced with permanent implant

Revisional Breast Reconstruction


Dr. Lettieri performs a revisional breast reconstruction when a woman has had a mastectomy with implants and she wants to replace the old implants with the newer high-tech gel implants. Patients come to him for revision surgery to correct problems with scarring or for nipple reconstruction or other reasons.  Replacing the old implants with new ones is sometimes necessary – other times it is just because the patients wants them.  Whatever the case, the new gel implants offer durability and comfort while achieving a natural looking appearance.