Minimal Scar Mastectomy – A Novel Nipple-Sparing Technique at KK Women’s and Children’s Hospital

Minimal Scar Mastectomy (MSM), a novel technique of nipple- sparing mastectomy without reconstruction, is enabling patients at KK Women’s and Children’s Hospital (KKH) with breast cancer to conserve their nipple-areolar complex with minimal post-surgical scarring.

Breast cancer is the top cancer affecting women worldwide, and develops when cells in the breast begin to grow out of control. In Singapore, it is estimated that one in 14 women develop breast cancer before the age of 75.

Pioneered by Dr Lim Geok Hoon, Senior Consultant, KK Breast Department, KKH, MSM has been introduced for select patients at KKH with breast cancer since March 2017. Arising from a combination of nipple-sparing mastectomy and the round block technique (an oncoplastic technique), MSM provides patients with an alternative to the long transverse chest scar associated with traditional mastectomy, with a more cosmetically pleasant concealed scar. MSM also enables the preservation of the nipple-areolar complex – which has been shown to improve the psychological well-being of patients.


In most cases of treatable breast cancer, surgery of the breast is usually required, and would involve either breast conservation combined with radiotherapy, or a mastectomy with or without reconstruction.

Traditionally, to spare the nipple during mastectomy, reconstruction would be mandatory to support the overlying breast skin envelope after the mastectomy has been performed. This would involve the use of implants or the patient’s own tissue, usually from the back or abdomen, which increases the duration and costs associated with the surgery.

During MSM, the skin around the areola is pre-operatively outlined to estimate the amount of breast skin to be removed. Thereafter, this excess breast skin is removed and mastectomy is performed using an incision around the areola, while preserving the nipple-areolar complex. The areolar wound is then closed in the same fashion as the round block technique.

This is the first reported surgical technique that is able to preserve the nipple-areolar complex in a mastectomy without the need for reconstruction. Should the patient choose to go for reconstruction in the future, the cosmetic outcome will also be better compared to a traditional mastectomy, since the transverse scar associated with the latter is avoided.


The eligibility criteria for MSM includes small breasts, with no evidence of cancer involving the nipple-areolar complex or a large area of breast skin. They would also need to have opted for mastectomy without reconstruction, and have the desire to conserve their nipple-areolar complex.

Although mastectomy with reconstruction will inevitably result in a better cosmesis as compared to without reconstruction, the decision to embark on reconstruction remains a very intimate one.

Given the high rate of patients with breast cancer who choose mastectomy without reconstruction locally, as well as a higher prevalence of women with smaller breasts in the Asian population, MSM can certainly be an option to consider for this group of breast cancer patients, allowing suitable patients to conserve their nipple-areolar complex with less scarring.


Patients diagnosed with breast cancer who are considering to undergo a minimal scar mastectomy can contact KKH at +65 6294 4050 for a consultation at the KK Breast Centre, which is a part of the SingHealthDuke-NUS Breast Centre.