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Breast Unit

Therapeutic Mammaplasty


Mr Richard Sutton in Theatre


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The Operation Advantages Disadvantages Related information

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The Operation

This is a new and increasingly popular technique to help with the surgical treatment for breast cancer. It is an operation that is frequently undertaken at the RUH by Mr Richard Sutton.

In essence this is a modified breast reduction type procedure and is a form of breast reconstructive surgery. It involves undertaking a very wide local excision of the tumour in the breast followed by surgery to remodel the remaining tissue and skin of the breast to create a new breast shape; one that is somewhat smaller, with less droop and hopefully a better shape.

The process is then repeated on the other breast to create as symmetrical a result as possible.

This is a particularly useful technique for those women who have a large (or multi focal) tumour because the traditional approach would have been to undertake a mastectomy.

However, using a therapeutic mammaplasty we can sometimes avoid the need for mastectomy, retaining the remaining healthy breast tissue to create a smaller breast and one that frequently has a more pleasing shape than before.

It can also be useful for women who have a relatively small tumour in a very large breast and who were contemplating breast reduction surgery in any case. In this instance it can be relatively straight forward to combine the wide local excision of the tumour with a breast reduction.

It is important to remember that after the operation radiotherapy would always be recommended to treat the remaining breast tissue. Treatment with radiotherapy will reduce the risk of breast cancer recurrence in the breast.

Radiotherapy will commence many weeks after surgery and only when all of the wounds have fully healed.

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Advantages

There are some additional advantages to undertaking therapeutic mammaplasty in addition to those benefits that are achieved through a standard breast reduction operation. These include:

  1. The operation can sometimes achieve a very wide local excision of the tumour. This may improve cancer treatment and reduce the risk of recurrence of cancer within the breast in the future.
  2. It can help with the delivery of radiotherapy. It is perhaps easier and safer to administer radiotherapy to smaller breast than to a larger one.
  3. A breast that is reconstructed using just breast tissue is more natural and stable when a compared to a new breast created with an implant or with tissue from elsewhere in the body. Recovery from the operation is also much quicker for most women.

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Disadvantages

However, there are some disadvantages to this approach that are important to understand:

  1. The operation will leave quite prominent scars to the skin of the breasts which are always impossible to avoid. For many women these scars will fade well with time, but for some the scars remain quite visible.
  2. The operation is more difficult and complex than standard breast surgery for cancer; such as a mastectomy or wide local excision. The operation takes longer to perform and you may have to a wait longer to have the operation after your diagnosis of breast cancer is made.
  3. There are greater risks for the development of post operative problems, such as infection or delayed wound healing. If these problems were to develop then there is a chance that any further medical treatment for breast cancer might be delayed (chemotherapy and radiotherapy).

    If a delay were to occur it is likely to be measured in days and weeks (rather than in months) and this will almost certainly not impair the chances of a treating the breast cancer successfully.

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Related Information

Many aspects of the operation are very similar in many respects to a standard breast reduction, including the surgical technique, scars, inpatient hospital stay and recovery. Please refer to the section on:

Also See:


Wide Local Excision (Lumpectomy)

Needle Localised wide local excision

Sentinel Lymph Node Biopsy

Axillary Lymph Node Dissection

Duct Excision

Mastectomy without reconstruction

Reconstructive Surgery




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Page updated: 28 October 2014