Breast Oncoplasty

BREAST ONCOPLASTY

We define the operation to remove malignancy from the breast with simultaneous restoration of its normal shape and projection. It is performed in patients with medium or large-sized operations (compared to their breast size) in which oncological surgery alone would remove a breast free of disease but morphologically altered and discordant with the contralateral healthy breast.

Early diagnosis and surgical removal of breast cancer together with modern treatments (radiotherapy, chemotherapy and hormone therapy) have spectacular results in patient survival. As a result, the number of women who, after the completion of their treatments or at the same time as their oncological surgery, request some cosmetic surgery on their breasts is constantly increasing.

WHO IS THE SURGERY FOR?

The operation is aimed at all patients with breast cancer, regardless of age, who are going to undergo surgery to remove the tumor and wish to keep a smaller but normal breast, to restore the nipple and areola - when its removal is deemed necessary - or /and to bring the two breasts into symmetry.

Although the operation belongs to the restorative operations of Plastic Surgery, it has a strongly aesthetic character and significantly improves the quality of life and functionality of the patients.

HOW IS THE OPERATION DONE?

The type of operation that will be chosen by the Breast Oncologist and the Plastic Surgeon depends on the type of oncological surgery and the patient's expectations. Important in decision-making are the size of the tumor, its location, the size of the breasts, the quality of the skin, the age and the plan of post-operative treatments.

As a general principle, the tumor is removed by the Oncological Surgeon and the breast that remains is reshaped by the Plastic Surgeon so that the breast regains its conical shape and the nipple with its areola are located at the most prominent point of the breast. The nipple is placed in its new position through a dermoparenchymal flap, which ensures its blood supply and innervation, while when it is removed, adjacent skin is used to recreate it. There are various techniques that can be used, but the doctor will judge which technique is indicated for each patient.

WHAT IS THE TYPE OF ANESTHESIA?

Breast oncoplasty is performed under general anesthesia in an organized clinic. The duration of the surgery is 1 to 2 hours, while due to receiving general anesthesia and the duration of the surgery, it is considered appropriate to stay in the clinic for a few hours and to mobilize immediately.

WHAT WILL THE SCARS BE LIKE AFTER THE SURGERY?

The type of scars depends on the surgery that will be chosen. The incisions are planned together with the Oncological Surgeon before the surgery, following the basic principles of Surgical Oncology and Plastic Surgery. The incisions heal and mature over several months and the scar they leave behind is always covered by the bra. The majority of women will undergo post-operative radiotherapy and chemotherapy, treatments which affect the rate of healing.

During this period you will be given instructions to avoid deformed scars, while you will enter a follow-up program to ensure the aesthetic result of your breast(s).

HOW LONG WILL THE RESULTS LAST?

The results are permanent and will remain stable but subject to changes brought about by gravity and time. Often the operated breast needs to undergo additional excision (to achieve healthy margins) or post-operative radiation. In both of these eventualities, the result may be affected.

WHAT ARE THE LIMITATIONS OF THE SURGERY?

Breast oncoplasty and symmetrization of the contralateral breast after oncological surgery is indicated for all patients who must undergo oncological surgery but do not want to have deformity. Difficulty exists when the limits of damage cannot be safely predicted. In these cases, it is recommended that cosmetic surgery be performed in a second year.

WHAT ARE THE RISKS OF THE OPERATION?

Together, the doctors will evaluate your general condition and history and decide if you are suitable for oncoplastic surgery. You will be informed about the possible complications and what needs to be done to reduce the possibility of their occurrence. You will also be asked to stop using supplements and medications that affect blood clotting and to refrain from smoking. The anesthesiologist will then talk to you about the type of anesthesia you will receive and the possible complications.

WHAT YOU SHOULD DO BEFORE SURGERY?

Depending on your age you will be given instructions on which medicines you may be taking and which should be stopped or replaced.

One week before the surgery you will need to take measurements to order a special bra, have your photo taken and sign the consent form.

WHAT TO WATCH OUT FOR AFTER THE SURGERY?

You stay in the clinic for a few hours to 24 hours, depending on the surgery. Your time off work must be calculated in one week.

Leaving the surgery you will wear a special bra which you will keep for 6 weeks. You will likely have a drain that will be removed in the first 24 hours, and you will need to be mobilized as soon as possible. Pain and swelling when present are easily treated. Because the sutures are intradermal there is no need to remove sutures.

WHAT IS THE COST OF BREAST ONCOPLASTY?

The cost of breast oncoplasty is calculated by adding up the fees of the clinic, where the patient is operated on and hospitalized, of the Oncologist General Surgeon, the Plastic Surgeon and the Anesthesiologist. The purchase of the special bra must be included in the costs.