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Who is suitable for LICAP flap? | Breast reconstructive surgery

Who is suitable for LICAP flap? | Breast reconstructive surgery


Breast cancer is the most common cancer in the UK, with around 150 new breast cancer cases occurring every day. Primarily in females, where the estimated risk is 1 in 7, breast cancer can be caused by several factors, including genetic disorders, obesity, and older age being the biggest risk. It is important to spot any breast cancer symptoms early for the best possible treatment.

To treat breast cancer, there are various treatments available that set out to remove all of the cancerous tissue. This will help improve the chance of survival and to stop the cancer from spreading. Breast cancer surgery may involve losing a vast amount of breast tissue, and in some cases, the breast may need to be reconstructed or completely removed.

This guide will explain what LICAP breast reconstruction is, which people are the most suitable for the procedure, and how Stephen McCulley can help.

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What is LICAP flap surgery?

LICAP (or Lateral Intercostal Artery Perforator flap) surgery aims to maintain as much of the natural breast shape as possible after breast cancer surgery. During breast cancer surgery, the surgeon will remove the tumour for a better survival rate. However, this may result in lost breast tissue.

Once this breast tissue has been removed, the space that is left will initially be filled with fluid, but this disappears. The empty space will lead to a permanent change in breast size if not treated.

What to expect during the surgery

During the LICAP flap, the plastic surgeon will replace the lost breast tissue. Most women have spare tissue around their arms. This new tissue is taken from the patient’s arms to reconstruct the space after the tumour is removed; usually from below the armpit.

Depending on whether the breast cancer surgery is successful, both the cancer removal and the breast reconstruction surgery can be done on the same day. The operation will typically last one to two hours, and the excision will leave a long scar on the side of the chest afterwards.

Find out more information on LICAP flap breast-conserving surgery here.

Who is LICAP flap suitable for?

Like all surgeries, lateral intercostal artery perforator flap tends to be more effective for certain candidates. These include:

Early-stage breast cancer

As breast-conserving surgery requires tissue, fat and sometimes skin to be removed, the LICAP flap may be more effective for patients whose breast cancer is on the outer part of the breast.

This is common in patients with early-stage breast cancer and is recommended as their tumour is often located on the lateral portion of the breast.

Healthy diet and lifestyle

Patients who maintain a healthy lifestyle and weight are more likely to be good candidates for LICAP flap surgery. If you are wanting breast-conserving surgery, it is recommended to keep generally healthy. This includes maintaining a healthy weight and non-smoker. Breast cancer patients who are smokers should try to stop or smoke as little as possible.

Healthier patients make better candidates for LICAP flap surgery, as this minimises the risk of surgical complications.

Small to medium-sized breasts

As the surgery requires the removal of tissue underneath the arm, a good candidate would have a healthy amount of breast tissue available. Preferably, this surgery is ideal for those with small or medium-sized breasts.

Cancer also needs to be small enough compared to the breast size so that a good amount of tissue can be removed. The excision will leave a scar that can be covered up.

If you are unsure on whether you are suitable for LICAP flap surgery, talk to your doctor or contact a specialist surgeon.

Who is LICAP flap not suitable for?

Although the LICAP flap is beneficial in retaining the breast shape as much as possible following cancer treatment, certain people will not be suitable for the surgery.

As aforementioned, suitable candidates for LICAP flap are those of a healthy weight and medium build. This factor helps decrease any surgical complications from occurring. Therefore, patients that are significantly overweight or smokers may not be suitable for lateral intercostal artery perforator flap. Consider losing weight before the surgery, or putting on weight if you are severely underweight. Talk to a specialist surgeon for the best advice.

Also, as a portion of tissue underneath the arms will need to be removed, those who have a small build may not be suitable. Alternatives, in these situations, should be considered.

What alternatives are there?

LICAP flap is just one type of breast-conserving surgery. If you are not suitable for this type of oncoplastic breast surgery, other options may be available.

LTAP flap

Likewise, to LICAP, the Lateral thoracic artery perforator flap (LTAP) also removes tissue from the lateral chest wall and can be combined with the former procedure. This surgery is recommended for breast cancer patients with smaller breasts, and if the tumour is in the central area.

Therapeutic mammoplasty

Another breast conservation technique is therapeutic mammoplasty. Once a tumour is removed in a breast cancer patient, this surgery modifies the breast shape immediately after the lumpectomy. This preserves the shape, tissue and sensation of the breast as much as possible.

Suitable candidates for therapeutic mammoplasty include breast cancer patients with larger breasts, which would be deemed unsuitable for LICAP flap. This may also be suitable for patients with heavier breasts who may also welcome a reduction.

Discover more about therapeutic mammoplasty and the benefits of this surgery here.

Frequently asked questions

What is a TDAP flap?

Thoracodorsal artery perforator flap (TDAP) is similar to the LICAP flap, as it aims to reconstruct the breast using the patient’s tissue after lumpectomy. The surgery is based on branches of the thoracodorsal artery.

At Stephen McCulley, this procedure has been replaced by the LTAP flap. Discover more about LTAP flap surgery here.

What scarring should I expect from the LICAP flap?

After the surgery, you will be left with a long scar from the excision created by the surgeon. This is typically along the side of the check towards your back. Due to the area, the scarring will be hidden under your arm or by a bra strap.

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Oncoplastic Breast Surgery Types: LICAP Flap | An Expert Guide

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Oncoplastic Breast Surgery Types: LTAP Flap | An Expert Guide