What is Therapeutic Mammoplasty?

Therapeutic mammoplasty is a type of surgery to save the breast. This procedure involves breast cancer removal combined with breast reduction surgery or breast lift. With therapeutic mammoplasty, the breast is reshaped and the nipple is made higher. It may be suggested if your breasts are big and you want them to be smaller, or if the area that needs to be removed is big compared to the size of your breast.

After a therapeutic mammoplasty, the blood flow to the nipple may not be enough, and part or all of the nipple may die. This happens about once in 100 times, but your risk increases if you smoke, have diabetes, or have very sagging breasts. If your risk of this is very high, your doctor will tell you and may suggest that the nipple be cut off as part of your surgery.

What are the advantages of this method?

A therapeutic mammoplasty has a number of benefits:

• You won’t have to get a mastectomy to get rid of cancer, and you won’t have to lose your breast.
• Unlike with a lumpectomy, you are much less likely to have a small change in the shape of your breast after the surgery. The goal of this procedure is to make the breasts look normal.
• For women with very big breasts or sagging breasts, this procedure can help make them smaller or gives a breast lift, which can be an added benefit.
• Getting better results from radiotherapy can be easier if you reduce the size of your breasts.

If you want to find out if you are a good candidate for therapeutic mammoplasty, give us a call today to set up a meeting with Dr Mansi Chowhan. She is an accomplished surgical oncologist who has been active in the medical industry for more than 12 years.

How does the procedure work?

On the day of the surgery, your doctor will mark your breasts and may take pictures of them. The anesthesiologist will also be there.

During the surgery, the tumour and the tissue around it are taken out first. Then, the shape of the breast is changed and the nipple is moved. The length of the surgery depends on the method used, but there are usually three different ways to do this operation:

Round block mammoplasty: A small piece of skin is taken from the areola, which is the dark skin around your breast. If the cancer is in the inner or upper part of the breast, your doctor will use this method. After the cancerous tissue is taken out, the areola is stitched up with stitches that dissolve over time. This method leaves a scar in the shape of a donut around the nipple.

Mammoplasty with a vertical scar: Again, a small circle of skin is cut away from around the areola, but this time, your surgeon will also cut down the middle of the lower part of the breast in a vertical line. This is done to get rid of cancer in the bottom part of the breast. After the tissue is taken out, the skin is stitched back together and the nipple is moved up higher than it was before. This method leaves a lollipop-shaped scar around the nipple and under the breast.

Wise-pattern breast surgery: The same cuts are made as before, but an extra one is made along the breast fold. With this method, your doctor can remove cancer from any part of the breast. It happens a lot and leaves a scar that looks like an anchor.

Therapeutic Mammoplasty: Aftercare

When you get a therapeutic mammoplasty, you will have more scars, and the surgery will take longer because it is more complicated. Your surgeon will tell you where the scars are likely to be on your breast, but in general, they will go around your areola (the dark skin around your nipple) and then straight down and possibly also along the fold underneath your breast.

After therapeutic mammoplasty, you are more likely to have problems with your wounds healing or to get an infection. This can delay your other treatments, like chemotherapy and radiation, because wounds can’t be treated until they are healed.

After surgery, your doctor will tell you how to care for your wound and breasts. Right after the surgery, you should wear a soft, supportive bra for up to six weeks, until the breast has fully healed.

Don’t drive, lift heavy things, or do the strenuous exercise until you feel better. You will also need to take time off work, usually about 2 weeks. Talk to your boss about this ahead of time. For about two weeks, you should sleep on your back at night.

In about 1 week, your surgeon will want to check on how well the breast is healing and talk to you about the results.

If you feel sick, have a high temperature, are throwing up, or have a lot of redness on your skin, go to your doctor or the emergency out-of-hours service. You might have an infection, and a doctor will give you antibiotics to treat it.

Who would benefit most from a therapeutic mammoplasty?

Therapeutic mammoplasties work best for people with large breasts who are willing to have their breast size reduced after treatment for cancer. People with sagging breast tissue (breast ptosis) or very big, heavy breasts may be glad to know that they can have breast reduction surgery simultaneously with tumour removal. But it can also help people who have smaller breasts that hang down.

Frequently asked questions

• How long does it take to get better after a therapeutic mammoplasty?

After this surgery, you can expect to stay in the hospital for one night, especially if you have a bilateral therapeutic mammoplasty. You might need drains on your wounds to help reduce swelling, but these are usually taken out before you are released from the hospital. After the surgery, you won’t be able to drive for at least two weeks, and you should stay away from hard work for a few weeks.

• How do you take care of your wounds after a therapeutic mammoplasty?

After surgery, wounds are protected with waterproof glue dressings. You can shower, and will be required to keep your wound site clean.

• How safe is surgery to save the breasts from cancer?

Most of the time, oncoplastic breast conservation surgery is safe. As with any surgery, there is a chance that something could go wrong, but you should know about these risks before the surgery.

Dr. Mansi is the best person to talk to about surgery for breast cancer

Dr Mansi Chowhan is a well-known surgical oncologist who has worked in his field for more than 12 years. She is an expert in breast oncoplastic surgery, head and neck surgery, and reconstructive surgery, which makes her a very good surgeon.

Dr Mansi has been a doctor for more than 12 years and has worked at some of the best hospitals in the Delhi-National Capital Region (NCR), like Fortis Healthcare (Delhi and Gurgaon), Artemis Hospital (Gurgaon), Paras Hospital (Gurgaon), and the Asian Institute of Medical Sciences (Faridabad).

The Onco Team