SUMMARY:: Skin-sparing mastectomy (SSM) is a surgical technique that preserves as much of the breast skin as possible. D.a.C.i. - Double asymmetric Circular incision is a novel immediate breast reconstruction technique for immediate prepectoral implant placement using a titanium-coated polypropylene mesh.The aim of this technique is to optimize the cosmetic benefits of smaller incisions, preserve breast anatomy, avoid breast deformities and reduce negative psychological impact on the patient without increasing local recurrence risk.D.a.C.i. SSM uses a double circular incision: the external drawing contains the nipple-areola complex (NAC), while the inner circular skin island will be used to provide the skin for the new areola.We performed D.a.C.i. SSM in patients with tumors located within 2 cm of the NAC, or in cases of patients with multicentric lesions involving areolar tissue.Forty-six patients underwent D.a.C.i. SSM at the authors’ institutions between February 2014 and July 2019. Two patients developed hematoma and one patient developed seroma. No implant loss was observed. Skin flap necrosis rate was 0%. The BREAST-Q patient-reported outcomes measure was routinely used at our institution and recorded good aesthetic outcomes and high patient satisfaction.This new technique appears to be safe and easily reproducible in patients with small- to medium-sized breasts and with little to moderate ptosis (up to Regnault classification grade II).