What Is Oncoplastic Surgery?
Oncoplastic surgery is tumor removal (lumpectomy) followed immediately by breast reconstruction. It's the integration of plastic surgery techniques into breast cancer surgery to preserve both quality of life and aesthetics, without compromising control of the disease. It includes three surgical activities: tumor removal (lumpectomy), breast reconstruction, and symmetry with the other breast.
Since traditional lumpectomy may distort the breast shape, oncoplastic surgery was designed to restore more normal appearance and symmetry, contouring both breasts at the same time for the best possible cosmetic result.
Planning begins well in advance, with consultation with you, your cancer surgeon, and your plastic surgeon. Since you and the surgical team have made most decisions prior to the surgery, the plastic surgeon knows exactly what will be done and is ready to proceed.
The stress and expense of a second surgical procedure are avoided.
The breasts will be symmetrical immediately after the surgery, and the problems of large or drooping breasts can also be improved at the same time.
Wound healing is a special issue in breast cancer patients. Your treatment will probably include a course of radiation therapy, which can slow down good wound healing. Oncoplastic surgery patients will do all surgical healing at one time, following the single surgical procedure. The wounds have the opportunity to completely heal, and radiation therapy can be started with reduced risk of wound problems.
The best candidates are women who can be treated with breast conservation (lumpectomy) and breast reduction or breast lift (mastopexy) procedures. These women have enough breast tissue to allow proper recontouring. Your surgical team will explain all of the risks and benefits and will help you decide which is the best option for you.
The procedure may be performed on an outpatient basis, or perhaps with just a single-night hospital stay.
Your breasts will be sore for a few days, but will improve quickly. If needed, you'll be given a prescription for pain medication. Drainage devices will probably be unnecessary. Your sutures will be removed after several days.
Recovery time is usually around six weeks, but many patients are able to return to work in half that time.
Every surgery has risks, including bleeding, infection, and anesthesia complications, but these are rare.
Occasionally the nipple and areola are found to have insufficient blood supply during the surgery, usually resulting from tumor lumpectomy location. In such cases a nipple graft may be performed, with removal and reimplantation of the nipple in its new location. This will cause nipple numbness and inability to nurse an infant. You and your surgical team will discuss this possibility in advance so you can make an informed decision about how to proceed should it arise.