Case #1304
Oncoplastic Reduction
68-year-old female with left breast cancer who wanted breast-conserving treatment. Dr. Azadgoli performed an oncoplastic reduction at the time of her lumpectomy. 200g of tissue was removed.
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Why this approach
The decisions that shaped this surgical plan.
- Oncology and reconstruction planned together rather than in sequence — the mastectomy pattern was selected to leave the best possible foundation for the reconstructive technique that followed.
- Unilateral case — the contralateral side was reviewed pre-op for symmetry goals. The technique was selected to match the untreated side in volume, shape, and position.
Pre-op preparation
What to do before surgery. Specific to this case.
- Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- Arrange button-front or zip-front tops for the first three weeks — overhead reaching is restricted. A drain holder or apron is provided.
- A driver is required the day of surgery and a responsible adult should stay with you the first 24 hours.
- Oncology results, imaging, and any chemotherapy timing reviewed in the pre-op visit. All coordination is handled in-house.
- Medical clearance and a current EKG are obtained pre-op. Anesthesia review confirms any chronic-condition adjustments.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
First week prioritizes drain care, walking short distances, and avoiding any overhead reaching. Multi-modal pain control keeps narcotic use brief.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Activity ramps slower than average. PT check-in at week 4 anchors the next phase.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
First major reconstruction assessment. Tissue softens, surveillance imaging if indicated coordinates here.
- Month 6
Final aesthetic emerges. Last-mile adjustments (fat grafting, nipple reconstruction) typically scheduled now.
Continued care
Recommended aftercare, skincare, and MedSpa services for Oncoplastic Reduction.
- Surgical bra continuously for 6 weeks
- Sleep elevated on your back for the first 2 weeks
- Drains, if used, removed at days 5–7
- Scar management protocol at 3 weeks
- Coordinate radiation timing with the oncology team
- Medical-grade silicone sheeting on the anchor or lollipop incisions
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ on incisions for 12 months
- LED light therapy weekly for the first 8 weeks
- Lymphatic drainage starting week 2
- Fractional laser for scar refinement after 3 months once cleared
- Coordination
Follow-up imaging schedule coordinated with the oncology team.
Post-mastectomy patients stay on a long-term surveillance pathway.
- Aftercare
Early lymphatic massage protocol initiated in the first week of recovery.
Lymphatic disruption from axillary work makes early drainage more valuable.
- Aftercare
Activity progression coordinated with PT — formal check-in scheduled for week 4.
Older patients benefit from a guided return-to-activity plan.
