The combination of plastic surgery and cancer surgery techniques extend the indications of conservative surgery to cancers previously treated by mastectomy. Oncoplastic surgery aims to treat cancer and provide an aesthetic result.
It treats cancer as it allows for a wide excision of tumor with excision margins outlying the tumor, the best guarantee of future local prognosis.
It provides an aesthetic result, as it helps prevent unsightly deformation of the breast, areola retraction or volume mismatch.
Oncoplastic surgery is performed on breasts with a sufficient volume and on a lumpectomy not exceeding one breast quadrant.
A different technique for each area...
Glandular flaps are created in order to remodel the gland and maintain the projection of the breast.
The procedure leaves a purse-string scar, or sometimes a short horizontal scar in place of the areola. The areola is rebuilt in a second procedure and hides the scar.
Several techniques are used depending on the location of the cancer, the aim being to preserve the look of the neckline, and create glandular flaps allowing immediate remodeling of the breast. The areola is usually preserved. The scar can be around the upper half of the areola with a short transversal extension ("batwin" technique), periareolar ("round-block" technique), or periareolar with a vertical and horizontal extension (breast surgery with lower pedicle).
Most often, a lumpectomy with an ellipse is carried out associated with a repositioning of the nipple-areolar complex to avoid the attraction of the areola to the outside. The gland is then remodeled to minimize the defect.
The procedure leaves a scar around the areola (periareolar scar) with a horizontal external extension (from the areola to the external mammary fold).
The classic lumpectomy in this location, especially on patients with large breasts and/or in case of ptosis, always leads to a very poor aesthetic result, with a lower volumetric defect that results in the areola and nipple sagging down.
The breast reduction technique helps avoid this distortion and obtain symmetrical breasts.