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Who is suitable for TDAP flap surgery? | A guide to oncoplastic breast surgery

Who is suitable for TDAP flap surgery? | A guide to oncoplastic breast surgery


Getting diagnosed with breast cancer is extremely difficult, and can sometimes have a large impact on both physical and mental health. It is always important to see a doctor as soon as possible if you notice any unusual symptoms such as a lump on the breasts.

In cases where a patient is diagnosed with breast cancer, breast cancer surgery is usually carried out to remove the tumour. Treatments to remove breast cancer tumours are constantly improving. In a recent study, for example, it was found that patient satisfaction after breast cancer surgery had improved over the years. However, breast asymmetry can still lead to negative emotions post-op. In these cases, oncoplastic breast surgery is a good alternative, as it combines breast cancer treatment with plastic surgery techniques.

This guide will explore what TDAP flap surgery is, and who is a suitable candidate for breast cancer treatment.

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What is TDAP flap surgery?

The thoracodorsal artery perforator flap (or the TDAP) is a piece of skin and fat which can be removed by a surgeon from the chest wall or the back. This surgery aims to help reconstruct the breast as effectively as possible following the tumour removal. During breast cancer surgeries, such as a mastectomy or lumpectomy, there may be subsequent loss of volume in the breasts due to removing the tumour. This can lead to breast asymmetry and subsequent dissatisfaction. This oncoplastic breast surgery method combines cancer treatment with plastic surgery techniques that prioritise breast reconstruction.

After the breast cancer surgery, the surgeon will then remove the skin and fat from the lateral chest wall (or the armpit area) for breast reconstruction. This skin will be used to reconstruct the areas in which the tumour was removed and has caused disproportions in the breasts. Once attached and reconstructed, the natural tissue will remain connected to its blood flow from the thoracodorsal artery perforator.

Find out more about TDAP flap surgery here.

What are the benefits of TDAP flap surgery?

This oncoplastic breast surgery method has various advantages over other techniques. Benefits of TDAP flap surgery include:

  • TDAP breast reconstruction retains as much natural breast as possible – this means that no breast implant will be needed.

  • Scarring and loss of sensation are minimised.

  • There can be a higher rate of satisfaction.

  • Shoulder strength is not affected – this is because tissue from the latissimus dorsi muscle is not used.

  • Less invasive than other breast conserving methods – this means that less physical therapy is required.

Who would be a suitable candidate for TDAP flap surgery?

Like other oncoplastic breast surgeries, some breast cancer patients will be more suitable candidates for TDAP flap surgery. Suitable candidates for TDAP flap surgery include:

Small to medium-sized breasts.

TDAP flap surgery will best suit patients that have small to medium-sized breasts. This is because the amount of skin and tissue required is typically much less than other procedures.

They will need enough healthy tissue that can be removed from the lateral chest wall area.

Do not want or cannot have a breast implant.

After treatments such as the skin-sparing mastectomy, in which after the surgery, a breast implant can be inserted, oncoplastic breast surgery retains as much natural tissue as possible. In TDAP flap surgery, skin and fat from the lateral chest wall are taken and transferred to the breast area, resulting in no need for breast implants.

Have had or need radiotherapy.

After breast conserving surgery, such as TDAP flap and LICAP flap, the recommended next step is undergoing radiotherapy. This is when high-energy x-rays are used to destroy any remaining cancer cells and to reduce the risk of breast cancer returning post-op.

Breast cancer patients, who have undergone TDAP flap surgery, can have an extra dose to this area.

Want to retain the natural breast shape and feel after surgery.

One of the main benefits of TDAP flap and other oncoplastic breast surgeries is that the breast appearance is considered throughout the breast reconstruction. The surgeon will try to retain the natural breast shape as much as possible.

If you are interested in finding out more about TDAP flap surgery, or to see if you are a suitable candidate, make sure to contact your doctor or a specialised oncoplastic breast surgeon. Stephen McCulley works extensively as a cosmetic plastic and reconstructive surgeon, including the utilisation of oncoplastic techniques in breast cancer surgery.

Who is not suitable for TDAP breast surgery?

In some cases, the TDAP flap is not suitable. This may depend on certain factors, including:

  • Breast cancer patients with large breasts.

  • Those with significant ptosis or sagging of breast tissue.

  • Health problems such as diabetes.

  • Severely overweight.

  • Smokers.

Specific factors that can be changed, such as losing an amount of weight or quitting smoking, should be advised. In these situations, breast cancer patients may find that they become suitable candidate. However, there are alternatives to TDAP flap surgery.

What are the alternatives to TDAP flap surgery?

If you find that you are an unlikely candidate for TDAP flap surgery, there are other breast cancer treatments available that combine tumour removal with plastic surgery.

Below are some of the most common types of oncoplastic breast surgery:

Type of oncoplastic breast surgery

Description

LICAP flap

Suitable for breast cancer patients where the tumour is on the outer part of the breast.

Therapeutic mammoplasty

Suitable for breast cancer patients with large or drooping breasts who are willing to undergo a breast reduction in their treatment.

LTAP flap

Suitable for breast cancer patients where the tumour is on the outer or central portion of the breast and occupies more than 10% of the overall breast volume.

Make sure you are undergoing the right breast cancer surgery by speaking to your doctor or specialist surgeon. Contact Stephen McCulley today to arrange a consultation to see if you are a suitable candidate for any of these oncoplastic breast surgeries.

Frequently asked questions

Are there any complications of TDAP flap surgery?

Following TDAP flap breast reconstruction, breast cancer patients can expect to experience some bruising and swelling following the surgery. This will usually ease gradually after a few weeks. There is also a rare chance of irregular contours of the breast and infection of the wounds.

For more information on the limitations of TDAP flap surgery, read our full guide on breast conserving surgery here.

How long does it take to heal after TDAP flap surgery?

TDAP flap surgery is less invasive than other types of reconstructive surgery, and therefore, the recovery period is not as long as other surgeries. After the surgery, the patient will typically only need to stay at the hospital for one night.

Once at home, strenuous exercise and movement should be limited and a full recovery can be expected anywhere between four and six weeks.

Find out more about the best recovery advice following oncoplastic breast surgery here.

What is perforator flap surgery?

Perforator flap surgery is a technique where skin, muscle and/or fat is removed from another part of the body. In this breast reconstruction, it is the thoracodorsal artery perforator that is used to ensure the same blood flow is utilised.

The surgeon does not touch the latissimus dorsi flap or muscle during TDAP flap breast augmentation.

Find out how LD flap reconstruction compares to oncoplastic breast surgery here.

Related content

Oncoplastic Breast Surgery Types: TDAP Flap | An Expert Guide

Oncoplastic Breast Surgery Types: Therapeutic Mammoplasty