This operation is suitable for patients with small to medium sized breasts where the cancer is in the outer part of the breast. It involves replacing the breast tissue which has been removed as part of the cancer operation with fat and sometimes skin from the chest wall. The most common procedure involves a LICAP (lateral intercostal artery perforator) flap. The artery supplying a roll of fatty tissue on the chest wall is identified using a Doppler probe prior to surgery. The flap is then raised and positioned in the space left behind once the cancer has been removed.
There is no scar on the breast unless it is necessary to remove skin as part of the cancer operation. There is quite a long scar on the chest wall within the bra line.
The operation aims to maintain the size and shape of the breast. However, most patients undergoing this surgery for cancer will undergo radiotherapy and this may impact on the overall appearance of the breast and may make it appear and feel different to the other side.
This operation can be performed as a one part or two part procedure. In a one part procedure the cancer surgery and the flap are performed at the same operation. If there is some doubt about the size of the cancer, the cancer operation may be performed first and the space left behind is filled with water. When it is confirmed that the cancer has been completely removed, the patient returns to theatre around 2 weeks later for a second operation to raise the flap and reconstruct the breast.
The recovery time is 3-4 weeks. The main risks specific to this operation are of flap failure, where the flap doesn’t have a good enough blood supply to survive (1-2%), fat necrosis where the breast can feel hard and/or lumpy and wound healing problems.
Your surgeon or breast care nurse will advise you whether this surgery is an option for you. It is not usually suitable for people who are cigarette smokers. As this operation only involves removing part of the breast radiotherapy treatment will also be required afterwards.