A modified mastectomy involves the removal of almost all of the breast tissue with the axillary lymph nodes. The pectoral muscles of the chest are preserved. Enough skin from the chest is preserved so the incision can be closed without tension. Most patients undergoing mastectomy will not require radiation therapy. At the time of mastectomy or later, the breast can be recreated with an implant or a muscle/skin rotational flap.

For implant reconstruction, a tissue expander is placed under the chest wall muscle at the initial surgery by a plastic surgeon. The expander is slowly enlarged by injecting salt water into it to stretch the overlying muscle and skin to the correct size. When the correct size is achieved, a permanent implant replaces the tissue expander.