For patients with high risk factors of breast cancer, preventive mastectomy can be taken. It can be bilateral or unilateral. The latter is a preventive mastectomy at the same time as a mastectomy. The incision is mostly along the nipple areola of the lower half ring, and sometimes it can extend to the upper side, which is convenient for operation. All the breast tissues were removed during the operation. If there is no obvious breast droop, the nipple and areola can be preserved in situ together with the breast skin (local flap). If there is breast ptosis, it is necessary to remove excess skin tissue, and the nipple areola can be freely transplanted to a new position. At the same time of preventive mastectomy, autologous tissue is often used for immediate breast reconstruction. After removing the epidermis and the original breast tissue, the skin flap is placed in the cavity. In order to facilitate the postoperative monitoring of the flap, a part of the skin of the flap is often reserved as a window.

After the flap survived, it was repaired by two-stage stripping.

Tumor surgeons and plastic surgeons cooperate closely before and during the operation, carefully design the incision, remove breast tissue, nipple areola, original biopsy site and corresponding invaded skin tissue, and preserve local breast flap as much as possible, which is beneficial to breast shaping. For those with big breasts, use a big chest incision. Its advantages are that it can preserve its own skin, reduce the skin requirements of transplanted tissue, and easily obtain the effect of symmetry with the opposite side.