Many of the advances in Oncoplastic breast reconstruction were developed here at Georgetown University Hospital. If you are considering lumpectomy or breast conservation surgery, there are reconstructive options to improve the cosmetic result of your surgery. The removal of part of the breast tissue may leave an indentation, like a dimple, in your breast. This dimple may not been seen initially, but could appear after radiation therapy if you need this additional treatment. To prevent to occurrence of this dimple, Dr. Pittman can arrange the breast tissue at the time of your cancer removal to appear more natural, called oncoplastic surgery. If there is a question that all of the cancer may not be removed in your initial surgery (this is called a positive margin) your mastectomy surgery and your reconstruction may take place in two different operations. If this is not an option at the time of your cancer surgery, reconstruction can occur later using other choices such as the latissimus dorsi or nearby (local) tissue flaps.

Often, oncoplastic surgery leaves you with a smaller breast than your natural breast. Dr. Pittman will then perform breast reduction to make your natural breast smaller and match the breast which had cancer surgery. This is a good option for patients who are candidates for breast conservation therapy, or lumpectomy, and are also candidates for breast reduction. This procedure generally involves three incisions:

1. A circular incision around the nipple and areola
2. A vertical incision from the nipple to the lower fold of the breast
3. A horizontal incision in the fold of the breast

Sometimes difficulty preserving blood supply to the nipple in surgery requires the nipple to be removed from the breast and then placed back on, also called a free nipple graft. Benefits of doing the bilateral breast reduction at the time of the lumpectomy include:

• Usually need only one surgery
• Completing the surgery prior to radiation, avoiding the risks of wound-healing problems when surgery is performed after radiation

This surgery may require the use of drain tubes to be inserted at the time of surgery which will be removed in approximately 5-7 days. The surgery may be outpatient or possibly one night in the hospital. The recovery time is approximately 4-6 weeks, but most people usually feel better and are able to return to work in 3-4 weeks.