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Who is suitable for LTAP flap? | Oncoplastic breast surgery

Who is suitable for LTAP flap? | Oncoplastic breast surgery


In the UK, around 55,000 women and 370 men are diagnosed with breast cancer every year. There are various types of breast cancer treatments to remove the tumour, and maintain a desirable breast shape and size. Occasionally, surgeons and patients favour oncoplastic breast surgery techniques, such as the TDAP, LICAP, and LTAP flap surgeries; but first, it is important to assess your suitability.

This guide will look at what the LTAP flap surgery includes, who is the most suitable candidate for the surgery, and what you should consider if seeking treatment.

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What is LTAP flap surgery?

Oncoplastic breast surgery is a breast conservation technique that combines cancer and plastic surgery techniques. Rather than solely focusing on removing the cancerous tumour, the cosmetic appearance is also prioritised throughout the surgery, as removal can cause the breast shape to appear asymmetrical. Depending on the blood vessel utilised, breast cancer patients seeking this type of treatment may undergo either LICAP flap (the lateral intercostal artery perforator), or LTAP flap surgery.

The lateral thoracic artery perforator (or LTAP) flap surgery aims to replace the lost breast tissue after breast cancer surgery; in combination with a lumpectomy. After removing the tumour, the surgeon will make an excision in the lateral chest wall (underneath the armpit).

The flap of tissue from the lateral chest wall is then attached to the breasts in order to fill the gap left by the lumpectomy; blood is supplied from the lateral thoracic artery.

What are the benefits of LTAP flap surgery?

After a lumpectomy, which removes part of the breast tissue, there may be significant deformity within the breast shape and size. This, in turn, may lead to concerns about the appearance of the breasts post-surgery.

One of the benefits of partial breast reconstruction surgeries, such as LTAP flap surgery, is that the cosmetic outcome is prioritised during treatment; meaning that care is put into maintaining as much of the natural breast shape and size as possible. A recent study into oncoplastic breast surgery found that patient satisfaction after LTAP flap surgery was at 88.5% (for either “excellent” or “good”), compared to other types of breast cancer treatments.

Find out more about LTAP flap surgery and the benefits of this partial breast reconstruction at the Stephen McCulley website.

Who would be a suitable candidate for LTAP flap surgery?

Partial breast reconstruction is a great way to maintain as much of a patient’s natural tissue as possible. Due to certain criteria, some breast cancer patients may find that they are more suited to LTAP flap surgery compared to other oncoplastic breast surgeries. This includes:

Small to medium-sized breasts

Like TDAP flap surgery, LTAP flap surgery will best suit breast cancer patients with small to medium-sized breasts. This is because less skin and tissue are required in this partial breast reconstruction, compared to other treatments.

Patients who have breast cancer in the outer part of their breast tissue

As a flap of tissue is used from the lateral chest wall during the breast reconstruction, it is helpful if the tumour is located on the outer part of the breast tissue. If the tumour is located elsewhere, the TDAP flap treatment may be more suitable.

It is also favourable if the tumours occupy more than 10% of the breast volume, and it would be beneficial to undergo LTAP flap surgery compared to a lumpectomy.

To compare oncoplastic breast surgeries with lumpectomies, read our Advice Centre here.

If the patient does not want breast implants

Breast implants can be used in partial breast reconstruction to help create a desirable shape after a lumpectomy or mastectomy. However, for those who are wanting to maintain as much of their natural tissue as possible, the LTAP flap surgery may be more suitable as this treatment utilises tissue from the lateral chest wall.

At Stephen McCulley, we understand the difficulties and considerations you may have to make when undergoing breast cancer treatment.

Who is not suitable for LTAP flap breast surgery?

Although LTAP flap surgery is one of the most popular partial breast reconstructive surgeries, certain candidates may not be suitable for the treatment. This includes:

  • If the patient has health problems, such as diabetes

  • If the patient is severely overweight

  • If the patient is a heavy smoker

  • If the patient has a small build

  • If the patient has large or droopy breasts (ptosis)

Before ruling any oncoplastic surgery out, make sure to consult with your doctor or a specialist surgeon who can assess your suitability. Stephen McCulley provides consultation with breast cancer patients to determine the best type of treatment.

Contact Stephen McCulley and his team today for more information.

Are there any alternatives?

Although you might not be a suitable candidate for LTAP flap surgery, there are alternative breast cancer treatments available, listed in the table below:

Type of breast cancer reconstruction

What does this involve?

When is it appropriate?

Therapeutic mammoplasty

After the tumour is removed, healthy breast tissue is used to reconstruct the breasts.

Suitable for breast cancer patients with larger breasts who are willing to undergo breast reduction.

TDAP flap surgery

After the tumour is removed, skin and fat is removed from the lateral chest wall for partial breast reconstruction.

Suitable for breast cancer patients with small to medium sized breasts to treat cancers in any part of the breast.

DIEP flap surgery

After a mastectomy, skin and fat from the abdomen is removed to then reconstruct the loss of breast.

Suitable for breast cancer patients with multiple or very large tumours, where a mastectomy is required.

Make sure to consult with your doctor or surgeon who will be able to assess your suitability and suggest a breast cancer treatment that will best address your needs.

How Stephen McCulley can help

Stephen McCulley is one of the leading surgeons for oncoplastic breast surgery, and takes a special interest in breast cancer and reconstructive treatments. If you are comparing the different types of oncoplastic breast surgery, make sure to consult with a specialist surgeon to find out which treatment you are suitable for.

Breast reconstruction testimonial:

“The opportunity to have reconstruction at the same time as mastectomy has certainly helped me psychologically –

in fact I have never experienced that feeling of loss that many woman describe and I can only think that is because the reconstructed breast is so good.”

– Anonymous patient

For more information, contact Stephen McCulley and his team today.

Frequently asked questions

How long does recovery from LTAP flap surgery last for?

Typically, after breast reconstruction, patients are expected to stay in the hospital for up to 3 days; however, this surgery is usually performed as a day case. Afterwards, patients should feel fully recovered and back to work between two and three months; so, it is important to ensure you take it steady and follow the surgeon’s recommendations.

What scarring should I expect from LTAP flap surgery?

During LTAP flap surgery, which combines a lumpectomy with plastic surgery techniques, there will be scarring where the surgeon has made a wide local excision. There will be a long scar, starting at the breast and running along the side of the chest. The scar is typically hidden beneath the arm or can be hidden under a bra strap.

If you experience a complication with your scarring, make sure to contact your surgeon or doctor for the best advice. Find out more about oncoplastic breast surgery scarring here.