Derived from the words "mammary" (breast) and "plastic" (moulding), mammoplasty is essentially the surgical reshaping of the breast. It was originally used by plastic surgeons as a procedure for breast reduction and lift. In this procedure, a portion of the lower breast is removed and discarded, the nipple is moved higher up on the breast, and the skin is then closed around the breast. This results in a smaller but lifted breast. This procedure has since been adapted for use in a breast cancer setting.
In a breast cancer setting, when mammoplasty is contemplated for reconstruction purposes, it is typically for cases where the cancer ranges in size between 20% to 40% of the entire breast. A lumpectomy is first used to remove the cancer. Then breast tissue (what would normally be discarded in a breast reduction) is reshaped and rotated to fill in the cavity left behind by the cancer. Mammoplasty is typically suited for larger breasted patients.
A mammoplasty performed for a cancer-affected breast is commonly known as therapeutic mammoplasty. After therapeutic mammoplasty is performed, it is common for there to be a significant difference in size between the breasts. Mammoplasty may then be performed on the other breast, such that it matches in size and appearance. Mammoplasty performed on the unaffected breast is known as reductive mammoplasty.
Illustration of a patient with a cancer in the left breast. Therapeutic mammoplasty is performed on the left breast, where the cancer is cut out and the bottom portion of that breast is rotated into that cavity. A reductive mammoplasty on the right breast to symmetrise the breasts is also highlighted
Procedure will leave the patient with breasts which are reduced in size and lifted, but they should be symmetrical
The key advantage to this reconstruction alternative is that the patient with a sizable cancer is able to avoid a mastectomy and can keep her breasts. A disadvantage will be the scars that are unavoidable, however these scars tend to fade over time and in most cases are concealed by the bra.