Typical Timing/Age
Most patients with breast cancer who do not require a mastectomy are candidates for an oncoplastic breast reduction at the time of a lumpectomy or after a lumpectomy.
Problem
Heavy, Large, Pendulous, and/or disproportionate breasts – with cancer or after a lumpectomy.
Procedure
Multiple different incision patterns and subsequent scar patterns are used depending the the existing breast size and shape AND the location of the tumor or former tumor. Some patients may only require a circumvertical (lollipop-shaped) scar in order to achieve the desired size reduction, weight reduction and lift. Most breast reduction patients require the addition of a horizontal scar at the bottom of the breast creating an “anchor-shaped” or “inverted T” scar to achieve the necessary reduction and lift. An oncoplastic breast reduction trades heavy & droopy breasts without scars for lighter & lifted breasts with scars. The most critical portion of the procedure are the pre-operative markings which are made before surgery in the pre-operative holding area. A breast reduction involves tailoring the skin envelope and careful re-arrangement of the internal glandular architecture to reduce & reshape the breast tissue while maintaining adequate blood flow to the nipple. The operation usually takes 2-3 hours.
Goal
Fill the defect after lumpectomy with breast tissue to minimize distortion after radiation therapy which tends to cause the surrounding tissue to collapse and contract into the lumpectomy cavity. An oncoplastic reduction also lifts, reshapes and reduces breast size & weight.
Facility
Surgery Center or Hospital
Preparation
Patients cannot be using any nicotine-containing substances.
Anesthesia
General anesthesia
Recovery
Hospital stay
Most can go home after surgery.
Assistance
You will be able to walk around, feed and bathe yourself. Depending on your pain medication requirements, you may not be able to care for others or drive a car.
Walking
You are encouraged to walk around the house as much as possible to help reduce the risk of DVT and thromboembolism.
Showering
After 48 hours you should remove your dressings and take a shower.
Exercise
You should do mild/gentle stretching exercises immediately after surgery to prevent your arm and chest muscles from getting tight. Light exercise is okay one week after surgery with your new breasts well supported. No arm exercises (other than stretching) for three weeks.
Sex
Wait 1 week because you don’t want to increase your blood pressure during the early healing period. After 1 week, sex is ok ONLY if your partner is able to resist touching your new breasts. You are the only person allowed to touch your breasts for the 6 weeks following surgery.
Work
Depending on your type of work you can resume light office work as soon as you feel you are able to do so. Most people take about one week off work following a breast reduction.
Swelling
Usually, it peaks around 3 days and gradually goes away.
Bruising
If present should subside within 1-2 weeks.
Inherent Risks & Complications
Hematoma, Seroma, Dehiscence, Wound healing complications, Infection, Poor scarring, Tissue necrosis, Need for revision, Complications related to anesthesia.
