Lumpectomy with Reduction Mammoplasty

Summary:

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A lumpectomy with reduction mammoplasty is a breast-conserving and reshaping procedure that removes breast cancer while simultaneously reducing and lifting the breasts for a balanced, natural appearance. It is particularly suitable for women with moderate to large breasts, where removing a tumour alone would cause deformity or asymmetry. The operation achieves both oncological safety and aesthetic restoration in one stage.

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What is a Lumpectomy with Reduction Mammoplasty?

A lumpectomy removes the tumour and a small rim of surrounding healthy tissue to ensure complete excision. When the tumour is large relative to the breast size, or located in an area that may affect breast shape, the remaining tissue can be rearranged using a reduction mammoplasty (breast reduction) technique.

This approach reshapes and lifts the breast to restore a natural contour while ensuring clear surgical margins. The opposite breast is often symmetrised during the same procedure for optimal balance and cosmetic outcome.

Before the Procedure

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• You’ll meet your surgeon and anaesthetist on the day of surgery to review the plan and discuss the position of scars and nipple placement.

• Bring your breast imaging and reports if performed outside the hospital.

• Bring your own surgical bra, which you will wear immediately after surgery. The bra should be soft, supportive, and non-underwired.

• You’ll arrive fasting, as instructed.

• The incision markings for tumour removal and breast reshaping will be drawn on your skin before surgery while you are upright to achieve the best cosmetic result.

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During the Procedure

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• Anaesthesia:

  • The operation is performed under general anaesthetic, so you will be asleep and pain-free throughout.

• Lumpectomy:

  • The tumour and a rim of healthy tissue are removed through a precisely planned incision that fits within the breast reduction pattern.

  • Specimen imaging (X-ray or ultrasound) confirms that the lesion and any biopsy marker have been fully removed.

• Reduction Mammoplasty:

  • The remaining breast tissue is reshaped, lifted, and reduced in volume as needed.

  • The nipple and areola are repositioned to a natural height while preserving their blood supply and sensation as much as possible.

• Symmetrisation of the Opposite Breast:

  • In most cases, the opposite breast is reduced and lifted to match the treated breast for symmetry.

• Closure and Dressings:

  • The incisions are closed with dissolvable sutures, and surgical glue or steri-strips are applied.

  • A light dressing is placed, and your own surgical bra is fitted before you leave the operating theatre to support both breasts.

• Duration:

  • The procedure usually takes 3–4 hours, depending on the tumour location and amount of reshaping required.

  • Most patients stay in hospital overnight.

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After the Procedure

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• You’ll be monitored in the recovery area and then return to the ward.

• A small drain may be used and is usually removed before discharge or at your first postoperative visit.

• You may experience mild discomfort, bruising, or swelling for the first few days, which can be managed with simple pain relief.

• Dressings are waterproof, and you can shower from the day after surgery.

• Continue wearing your own surgical bra day and night for at least two weeks to support the new breast shape and aid healing.

• Avoid strenuous activity, upper-body exercise, or heavy lifting for two to three weeks.

• Driving is permitted after your first postoperative review, once arm movement is comfortable and you are no longer taking strong pain medication.

• Breast contour and scar appearance will continue to improve with time. Early swelling or irregularity is common and not concerning. The final result usually settles over several months.

Your pathology results will be ready within 7–10 days and will be discussed at your follow-up appointment.

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Possible Risks and Side Effects

Although generally safe, possible risks include, but are not limited to:

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• Bleeding or haematoma

• Infection

• Seroma (fluid collection)

• Fat necrosis (small firm lumps in the breast)

• Partial or total nipple loss (rare) due to poor blood supply

• Asymmetry between the breasts

• Temporary changes in nipple sensation

• Delayed wound healing along the incision lines

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Benefits of Combining Lumpectomy with Reduction Mammoplasty

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• Removes the tumour safely with clear margins while reshaping the breast

• Achieves a lifted, natural contour after cancer surgery

• Reduces breast size and improves comfort (less neck, back, and shoulder strain)

• Provides better symmetry by adjusting both breasts during the same procedure

• Improves radiation delivery and tolerance, reducing the risk of radiation-related skin toxicity and fibrosis in larger breasts

• Excellent long-term aesthetic and psychological outcomes

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Key Points

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• Combines cancer removal and breast reshaping in one operation

• Ideal for patients with moderate or large breasts

• Bring your own surgical bra (soft, non-underwired, supportive)

• You can shower from the day after surgery

• Wear the surgical bra continuously for at least two weeks

• Driving permitted after your first postoperative review

• Breast contour and scars improve gradually over time

• Typical hospital stay: one night, with a small drain in place if required