Oncoplastic breast surgery: recovery
Oncoplastic breast reconstruction surgery is sometimes recommended as part of a patient’s breast cancer treatment plan. Oncoplastic methods such as the TDAP flap and therapeutic mammoplasty are favourable to mastectomies and total breast reconstructions in early stage breast cancer as they avoid the use of implants, retain sensation in the breast(s) and avoid many of the risks and complications associated with alternative reconstructive methods.
However, like any surgery, oncoplastic techniques involve a period of recovery that you should be aware of if you are considering one of these procedures.
This article will discuss the recovery process for oncoplastic reconstructive breast surgery in comparison with alternative methods. It will also provide some tips for making recovery as smooth as possible after an oncoplastic procedure.
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- How difficult is it to recover from oncoplastic breast surgery?
- How long will it take to recover from oncoplastic breast surgery?
- Tips for recovering from oncoplastic breast surgery
- Frequently asked questions
How difficult is it to recover from oncoplastic breast surgery?
While the DIEP flap and LD flap use natural tissue and muscle to rebuild breast shape (typically without the use of breast implants), they are generally used for total breast reconstruction following mastectomy and are therefore larger operations. They are also often done as a delayed rather than immediate reconstruction method. This means that they are carried out some time after a mastectomy. Additionally, using the latissimus dorsi muscle from the back or tissue and muscle from the abdomen to reconstruct the breasts is a highly sensitive surgery that can take a long time to recover from.
On the other hand, oncoplastic breast surgery is somewhat easier to recover from. In many cases, patients can go home the same day as the surgery. After a procedure like the LICAP flap, you will likely experience some soreness in the arm/shoulder area but stiffness will generally be avoided. This can be managed easily by your surgeon through local anaesthesia and anti-inflammatory drugs. Swelling in the affected breast(s) is also normal post-surgery, but this can also be managed with appropriate pain relief.
Overall, the recovery period for oncoplastic surgeries starts earlier than alternative methods, and is generally shorter and simpler.
How long will it take to recover from oncoplastic breast surgery?
Oncoplastic methods aim to complete two objectives at once: removal of the tumour(s) and reconstruction of the breast in a single surgery. Many patients can be treated as a day case, though occasionally some may need to stay overnight in hospital. Other surgeries like the DIEP flap and LD flap can require a longer hospital stay. This means a breast cancer patient will begin recovery much sooner after an oncoplastic reconstruction. You’ll also regain mobility faster, needing less physical therapy since the surgery doesn’t use muscle.
Expect around four to six weeks of recovery after surgery, during which you’ll have to take care of the incisions on at least two parts of your body: the reconstructed breast(s) and the site where the tissue was taken to rebuild breast shape and size. Bruising and swelling of the reconstructed breast(s) can occur in the days following surgery. During this time, the breasts may feel heavy and uncomfortable, but this will ease. It may take up to a year for the breast shape and scars to settle completely.
Tips for recovering from oncoplastic breast surgery
After the surgery, you should avoid wearing tight-fitting clothing and wear a comfortable support or sports bra throughout your recovery. The support bra will help reduce swelling and prevent other complications. After four weeks, your doctor may encourage you to start wearing different types of bras that you’ll find comfortable, except an underwire one.
You should limit your movements as much as possible during the first few days after your surgery. Pushing, pulling, lifting, or any movement that causes your arms to strain should be avoided. Doing so could cause damage to the recovering tissues or open the wounds.
Start gently when resuming your exercise regime and stop if you find it too painful or strenuous. Additionally, avoid aerobics or other exercises that need vigorous body movement. Walks are recommended since blood circulation is vital for preventing clot formation.
Like exercising, you’ll need to avoid work duties that put too much stress on your arm, sides, back and chest area. You also need to avoid sitting too much. Incorporate some movements into your day and only work for a few hours, or, ideally, take this period off work. It is recommended that you liaise with your employer to ensure ample time for rest and recovery.
Avoid sleeping on your sides or stomach for at least four weeks. The best position in the first few days after your surgery is on your back with your upper body elevated; this helps reduce swelling and bruising. After one week, you may be able to sleep flat if you feel more comfortable doing so.
Because of your discomfort, limited mobility and the effects of pain medication, you should not drive for the first few days. It is advisable to wait for approval from your doctor before you resume driving. If you need to go anywhere, see if anyone will assist you by driving you to and from your destinations.
Staying hydrated and following a balanced diet is important to provide your body with the energy it needs to heal. The ideal diet should include fresh berries, Vitamin C-rich foods, dark leafy greens like kale, nuts, eggs, whole grains and proteins such as tofu or chicken. Avoid smoking and carbonated, alcoholic, or caffeinated drinks.
If you feel any unusual symptoms, you need to call your doctor immediately. Examples include sharp and uncontrollable pain, excessive bleeding, swelling in other body parts, a high fever, swollen and hot breasts, nausea and vomiting. The Stephen McCulley team are available if you have any questions or would like to find out more.
Frequently asked questions
Will I regain nipple sensation in the operated breast(s) after oncoplastic surgery?
Each patient is a unique case, but most breast cancer patients eventually regain nipple sensation after oncoplastic surgery.
What will the operated breast(s) look like immediately after oncoplastic surgery?
Surgeons try to maintain the original shape and nipple location as much as possible during surgery. However, there will be a noticeable difference in cases of breast reduction. However, oncoplastic surgery tries to keep both breasts symmetrical and as natural-looking as possible.
What kind of scars can I expect after oncoplastic breast surgery?
Breast cancer surgery means making an incision on your chest to remove the tumour(s). This will leave a scar. When reconstruction using your own tissue is involved, there is an additional incision site where the tissue is taken from. Because the oncoplastic method uses plastic surgery techniques of reconstruction, aesthetics is a high priority. Your surgeon will try to keep your scars along the bra line so that they can be covered easily.
Depending on the method you opt for, the scarring along and around the breast and nipple will look different.