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Reduction Mammaplasty Techniques for Oncoplastic Surgery

Introduction Oncoplasty is a popular technique for managing partial mastectomy defects that continues to gain momentum among plastic surgeons and oncologic breast surgeons alike. It is now widely accepted as a superior approach for reconstructing partial mastectomy defects, especially in the setting of postpartial mastectomy radiation. The advantages are that oncoplasty expands the candidacy for breast conservation therapy to patients with larger tumors who would otherwise…

Volume Displacement and Volume Replacement Techniques

Introduction Breast conservation therapy, or partial mastectomy, continues to be a popular treatment option for breast cancer patients. As a result, the demand for suitable oncoplastic reconstructive options is imperative. This trend has been supported by the increased use of neoadjuvant chemotherapy, rise of mammographic screening leading to earlier detection of breast cancers, and proliferation of breast cancer reconstruction awareness. Advancements in partial breast radiation therapy…

Plastic Surgeon’s Approach to Oncoplastic Breast Surgery

Introduction Oncoplastic breast surgery has become a common option for women with breast cancer and is currently being performed throughout the world on a regular basis. This operation has provided women with the best of oncologic and reconstructive options in that they can achieve oncologic safety and efficacy, retain the majority of their breast, and retain a natural breast appearance. In many parts of the world,…

Breast Surgeons and Oncoplastic Surgery

Breast surgeons utilizing oncoplastic techniques is commonplace in the United Kingdom, Europe, and parts of South America. In Canada and the United States, the adoption of oncoplastic surgery by breast surgeons has been slow to advance. Many factors play a role in the slow adoption, but education and training are most likely the greatest obstacles breast surgeons face. Breast surgery has evolved into its own specialty,…

Oncoplasty versus Mastectomy: Decisions and Outcomes

Introduction As reconstructive techniques have improved, patient expectations have evolved. From the simplest to the most complex resection, patients expect to be satisfied with their final esthetic result. Trying to decide on the operation that is best for patients now involves not only understanding the tumor biology but also patient preference and how to achieve the best esthetic results. Patients can choose breast conservation with or…

Indications and Patient Selection for Oncoplastic Breast Surgery

Introduction The newly diagnosed breast cancer patient and her interdisciplinary treatment team must address both the local control (breast) and systemic control (body) issues to minimize the risk of recurrence. From a surgical perspective, the fundamental goals are to remove the tumor with an adequate margin of normal tissue while optimizing the long-term aesthetic outcomes for the patient. The technical decision then becomes whether to proceed…

Safety of Oncoplastic Breast Reconstruction

Introduction Historically, early stage breast cancer has been treated with either mastectomy or breast conservation therapy (local tumor excision with adjuvant radiation therapy). Clinicopathologic characteristics such as tumor size and extent of breast involvement determine patient suitability for one approach or the other. Landmark prospective studies have shown that these two approaches have equivalent disease-free and overall survival. Total mastectomy can be a cosmetically deforming and…

Introduction to Oncoplastic Breast Surgery

Oncoplastic breast surgery has become a common option for women with breast cancer. Oncoplastic surgery is defined as tumor excision with a wide margin of resection followed by immediate or staged immediate reconstruction of the partial mastectomy defect. It differs from traditional breast conservation in that the margin of excision is significantly wider ranging from 1–2 cm rather than 1–2 mm. Oncoplastic breast surgery has been…

Endoscopic breast conserving surgery with immediate partial breast reconstruction using robot-assisted harvest of pedicled omental flap

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Endoscopic video monitors (Olympus Optical Co., Tokyo, Japan) were set up on both sides of the patient's head to allow…

Robotic mastectomy with immediate latissimus dorsi flap reconstruction

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Axillary staging procedure In patients for whom sentinel lymph node biopsy (SLNB) is indicated, a small amount (2–3 mCi) of…

Robotic mastectomy with immediate implant reconstruction

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Axillary staging procedure In patients for whom sentinel lymph node biopsy (SLNB) is indicated, a small amount (2–3 mCi) of…

Robotic breast-conserving surgery with immediate pedicled latissimus dorsi flap reconstruction

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Axillary staging procedure In patients for whom sentinel lymph node biopsy (SLNB) is indicated, a small amount (2–3 mCi) of…

Robotic mastectomy

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Axillary staging procedure In patients for whom sentinel lymph node biopsy (SLNB) is indicated, a small amount (2–3 mCi) of…

Endoscopic mastectomy with immediate latissimus dorsi flap reconstruction

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Endoscopic video monitors (Olympus Optical Co., Tokyo, Japan) were set up on both sides of the patient's head to allow…

Endoscopic mastectomy with immediate transverse rectus abdominis flap reconstruction

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Endoscopic video monitors (Olympus Optical Co., Tokyo, Japan) were set up on both sides of the patient's head to allow…

Endoscopic mastectomy with immediate implant reconstruction

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm abducted to 90 degrees to avoid affecting the operative procedure. Endoscopic video monitors (Olympus Optical Co., Tokyo, Japan) were set up on both sides of the patient's head to allow…

Endoscopic breast-conserving surgery with immediate local advancement/perforator flap reconstruction

Description of technique Pre-operative marking and positioning Pre-operative marking was done with the patient in standing and supine position. After induction of general anaesthesia, the patient was then placed in the supine position and ipsilateral arm raised above the ahead and secured to avoid affecting the operative procedure. Endoscopic video monitors (Olympus Optical Co., Tokyo, Japan) were set up on both sides of the patient's head…