1. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 Sentinel node biopsy incision and exposure. Figure Legend:

2. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 Breast and sentinel lymph node incisions for biopsy sites near the areola. Figure Legend:

3. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 A separate incision is made for biopsy sites distant to the areola. The blood supply to the intervening skin must be maintained. Figure Legend:

4. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 A lateral extension may be necessary to provide adequate exposure to the underlying breast tissue and, if necessary, the axilla. Figure Legend:

5. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 Friedman scissors are used to perform the sharp dissection between the tissue and the subcutaneous fat layer. Figure Legend:

6. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 Cautery device is used to dissect the breast from the pectoralis major muscle. Figure Legend:

7. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 Axillary dissection can be carried out through the skin-sparing mastectomy incision, with retraction by means of a Richardson retractor. Figure Legend:

8. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 If visualization of the axilla is difficult from the periareolar incision, the sentinel node incision is extended and a formal axillary dissection is performed. Figure Legend:

9. Date of download: 6/1/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin-Sparing Mastectomy With Sentinel Lymph Node Dissection: Less Is More Arch Surg. 2001;136(9):1069-1075. doi:10.1001/archsurg.136.9.1069 With the specimen removed, the breast skin forms an "envelope" that the myocutaneous flap will fill. The specimen can be removed en bloc or in 2 parts. Figure Legend: