restoreOncoplastic Breast Reconstruction

Tissue Rearrangement After A Lumpectomy

Lumpectomy is the most commonly performed type of breast cancer surgery and is often referred to as breast conservation surgery. Unlike a mastectomy, which removes the entire breast, a lumpectomy only removes part of the breast, consisting of the cancerous region and some of the normal surrounding breast tissue. The removal of the surrounding tissue is done to ensure complete eradication of the cancerous tissue.

Although a lumpectomy is considered a breast conserving surgery, the procedure can still leave the patient with undesirable cosmetic results. The individual may be left with a scar and an indentation where the cancerous tissue was removed instead of the smooth full contour their breast used to have. If a significant amount of tissue is required to be removed during the lumpectomy, the patient may be left with breast asymmetry. Also, it is important to note that radiation changes can and often do occur over the course of three years. A lumpectomy defect that is small and initially acceptable can change over time and may create an undesirable deformity later.

Oncoplastic reconstruction combines breast reconstruction with a lumpectomy. This type of reconstruction involves rearranging the breast tissue to hide the defect created from the lumpectomy. Typically, oncoplastic reconstruction involves operating on both breasts, the cancer and non-cancer side, to achieve optimal symmetry. For patients who opt for breast conservation surgery, oncoplastic reconstruction may be performed at the same time or soon after their breast cancer surgery.

The goal of oncoplastic reconstruction is two-fold:

1. The breast tissue is rearranged by the plastic surgeon at the time of the lumpectomy to camouflage the tissue defect.
2. The contralateral breast is addressed to achieve symmetry typically by performing a breast reduction or breast lift.

Women with a greater volume of breast tissue tend to make better candidates for reconstruction after a lumpectomy. Women with smaller breasts typically do not have enough remaining breast tissue after a large lumpectomy to perform a tissue rearrangement. Smaller busted patients who have significant breast distortion from a prior lumpectomy may require a completion mastectomy or flap reconstruction for improved cosmetic results.

If only a minimal defect is left after your lumpectomy, it is possible to improve breast contour and symmetry with fat grafting alone. Fat grafting is a minimally invasive technique where liposuction is performed in an area of excess fatty tissue, the fat is processed, and then injected into the breast. Fat grafting has the added benefit of improving skin quality after radiation therapy.

During your initial consultation, Dr. Spiegel will work closely with you and will coordinate with your general surgeon to determine what breast reconstruction options are best for your situation.