Firstly, exactly what is “Oncoplastic Surgery”?
Oncoplastic Surgery is the use of “Plastic and Reconstructive” surgical techniques in the treatment of cancer. It applies to all areas of cancer where plastic surgery techniques are used to remove a cancer with minimal negative functional and cosmetic effect or to repair and reconstruct such negative effects after the removal of a cancer. It has application in almost all areas of the body, from the more simple situations, such as skin cancers, though to the most complicated situations, such as major head and neck cancers and intra- abdominal and pelvic cancers.
Breast reconstruction surgery has been the domain of Plastic Surgeons for over 40 years. Plastic surgeons have developed a variety of techniques of reconstruction to best suit individual patient needs after mastectomy. These include Tissue Expansion Reconstruction, Prosthetic Reconstruction, Flap Reconstruction, Microvascular Flap Reconstruction and Fat Transfer Reconstruction along with Nipple/Areolar Reconstruction. Recently the term “Oncoplastic Breast Surgery” has become associated with breast cancer treatment. (It is important to be aware that not all surgeons performing oncoplastic breast surgery are Plastic Surgeons.) Given the incidence of breast cancer, breast reconstruction has an ongoing and increasing place in the management of breast cancer in the hope of optimising the patients’ well-being.
So what is Oncoplastic Breast Surgery all about?
Let’s get one thing straight. Treating and hopefully curing your breast cancer must be your No. 1 priority. Be sure to get that part of your treatment arranged fully and optimally. Breast reconstruction must be a secondary consideration. That does not mean you can’t have a reconstruction immediately or at a later date, but reconstruction must be seen in the full context of your breast cancer.
When you are first diagnosed with breast cancer, you may well be in a topsy-turvey state of information overload and anxiety. (Be wary of Dr. Google and trust your Surgeons.) Try and think of a “flow-chart” of treatment. It starts at the top left with your diagnosis and finishes at the bottom right with you being disease free and reconstructed. Your individual needs regarding cancer treatment and how these treatments fit with your individual suitability to reconstruction will all be a part of that flow-chart.
This analysis will allow decisions to be made about your suitability to immediate reconstruction or whether delayed reconstruction is the better option for you. It will also determine what type of reconstruction is most suited to your circumstance. Talk with your plastic surgeon. Tell him your concerns and preferences. Importantly, be guided by him.
Plastic surgeons are continually exploring and developing oncoplastic breast reconstruction techniques. Broadly speaking they will involve using a breast prosthesis alone, using a breast prosthesis covered by a flap of your own tissue or using a large flap of your own tissue by itself. Additional oncoplastic procedures include fat grafting, nipple reconstruction and areolar tattooing or grafting. Your Plastic Surgeon will be thinking about all the options which may apply to you from the day he first meets you and every time he sees you after your surgery.
So Oncoplastic breast surgery is Plastic Surgery used for reconstruction in patients who have breast cancer. The aim is to provide the most normal and acceptable replacement of your removed breast tissue with minimal complication and maximal satisfaction. Treatment of your cancer, Timing of your operation and Technique suited to your situation are paramount to achieving this.
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