At Lawrence Plastic Surgery, we have been performing breast reconstruction following partial mastectomy and total mastectomy for over 20 years. We are constantly looking at new techniques and exploring the latest ideas to help you achieve a good long-term cosmetic result from your cancer operation. Our board certified plastic surgeon, working with a dedicated staff that includes a certified plastic surgery nurse, will work with you and your other doctors every step of the way. Please use this guide as a starting point to exploring your options. We’re here to help any way we can.
Many patients have breast cancer that can be effectively treated without removal of the entire breast. Your general surgeon removes the tumor, along with a margin of surrounding normal tissue, in an operation known as a partial mastectomy or lumpectomy. After a period of healing, this is often followed by radiation treatments to the affected breast.
The appearance of the breast following partial mastectomy and radiation can often be quite good, with the breast maintaining good shape and symmetry relative to the opposite breast. The shape and size of the breast before surgery, the location and size of the tumor and the response of the breast tissues to radiation all influence the cosmetic outcome of the surgery.
Plastic surgeons are sometimes involved in the care of partial mastectomy patients to improve their cosmetic outcome. In cases where the breast shape, tumor size, or tumor location creates difficulty in preserving the breast shape and symmetry you may be referred to our office for a consultation to discuss the prevention or correction of breast deformities following partial mastectomy.
This guide provides an outline to the ways we may be able to help you achieve the best possible outcome from your partial mastectomy.
Before your partial mastectomy
Your general surgeon may refer you to our office prior to your partial mastectomy. At this consultation we will discuss how we might assist you and your surgeon to improve your cosmetic outcome. We can work with your surgeon to either provide advice regarding scar placement or make plans to participate in your operation using oncoplastic techniques. We can also discuss the types of corrective operations we might perform at a later time should it be necessary to improve your cosmetic outcome. Of course, we will discuss our thoughts and recommendations with your general surgeon and work with them as needed to maximize your results.
Over the years we have been called upon to correct partial mastectomy defects long after the initial surgery has taken place. This has helped us better appreciate how incisions placed at the time of the original surgery can make future correction easier (or more difficult). Using this knowledge, we can suggest incision patterns which are more favorable to the future correction of defects should this be necessary. With proper planning and consultation, we can sometimes help to prevent significant asymmetry and distortion from occurring.
When patients are seen months or years following their partial mastectomy and radiation, we have options available to either treat the affected breast or alter the opposite breast to achieve better symmetry. We generally like to wait 6 months or more after radiation is complete before performing these procedures. This allows the tissues of the treated breast to stabilize and allows us to better understand the degree of asymmetry present and what might be done to correct it.
This newly evolving concept of breast cancer care involves careful collaboration and planning between your general surgeon and plastic surgeon to adequately excise your tumor while repairing the breast to maximize the cosmetic outcome. Often your general surgeon and plastic surgeon will participate in your cancer operation together to remove the tumor, reshape the remaining breast, and possibly alter the opposite breast in a single operative procedure. While we have found this technique especially useful in patients with large breasts who would be candidates for breast reduction surgery, these techniques are also useful in patients with moderate sized breasts.
Correction of defects following partial mastectomy and radiation
We often see patients months or years after their partial mastectomy and radiation for correction of asymmetry or breast defects related to their treatment. While we would be happy to see you at any time, we usually advise waiting for at least six months following your last radiation treatment before undergoing surgery to allow the tissues to recover and ensure the best possible healing.
Radiated breast tissue may not heal as well as normal tissue. Therefore, for some patients we may recommend treatment of the opposite breast as the most straightforward way of achieving symmetry. This often involves a breast lift or breast reduction, as shown below.
When the radiated breast shape is intact, but the overall size of the breast is small, we may suggest a breast implant be placed to bring the breasts to an equal size.
A relatively new technique for correcting defects caused by partial mastectomies is fat transfer. Fatty tissue is suctioned, usually from your abdomen, and injected into the breast to correct the deformity.
Procedures to correct defects following partial mastectomy typically can be performed on an outpatient basis and do not require hospitalization. Most of these procedures are covered by your insurance policy, but we will need to send a predetermination letter to your company prior to the procedure to confirm this. Recovery time following surgery varies depending on the procedure performed, ranging from a few days to 2-3 weeks.
We have used a variety of techniques over the years to help our partial mastectomy patients achieve better symmetry, sometimes combining techniques to achieve the best possible results. We look forward to working with you and your other physicians in any way we can to achieve a good long-term outcome following your breast cancer treatment.