Display Patient Information Leaflets

Date issued: September 2025  

For review: September 2027 

Ref: A-684/SJL/Breast Care/Therapeutic Mammoplasty

PDF: Therapeutic mammoplasty.pdf [pdf] 247KB

Therapeutic mammoplasty is an operation to remove the breast cancer (therapeutic) and then reshape the breast by removing skin and breast tissue (mammoplasty), to leave a new breast shape that will usually be smaller and more uplifted. 

There is a limit to how much breast tissue can be removed with a standard lumpectomy without adversely affecting the appearance of the breast, but this technique allows us to remove more breast tissue and leave an acceptable cosmetic outcome. 

What scar pattern can I expect?

This operation can be completed in several ways, but the most common types of scars are as below:

•  Round block mammoplasty (Peri-areolar)

•  Vertical scar mammoplasty 

•  Wise pattern mammoplasty (Inverted T or anchor incision)

•  Lateral mammoplasty

•  Batwing

•  Melon slice

Considerations

• The technique aims to produce a close-to-normal breast shape with no indentation or distortion.

• Most women undergoing this operation require radiation therapy to the breast following surgery. For women with large breasts, reducing the size can reduce the risk of severe radiotherapy side effects.  

• The surgery is more complex than a simple lumpectomy with more scarring and potentially more complications. 

• The surgery may mean your breast is smaller and sits higher due to the amount of breast tissue that has been removed. Therefore, you may be asymmetrical (lop-sided) 

• Surgery to reduce the size of your other breast may become necessary to match you up. Such an operation is usually performed at a later date but can occasionally be performed at the same time.

• Occasionally it may be necessary to remove the nipple if the breast cancer lies close to the centre of the breast. If removal of the nipple is required a new nipple can be reconstructed at a later date. A tattoo in the shape of the nipple and areola can also be performed later, however, this service is not offered by the NHS. Where possible, your surgeon may offer you a free nipple graft during the same operation, as an alternative to nipple reconstruction or nipple tattoo. 

Potential complications of Therapeutic Mammoplasty operation specifically 

• Haematoma, 1 in 10 people

• Wound infection, 1 in 10 people

• Re-excision (need for further surgery): 1 in 5 people. If we are unable to get a clear margin of normal tissue around the lump, then usually further surgery will be required. If this is needed, it may be done through the same incision but other times a mastectomy may be advised. 

• Delayed wound healing. 1 in 10 people

• Nipple complications: 

  Impaired blood supply; 1 in 100 people approximately. The operation by its nature partially disrupts the blood supply to the nipple. There is a risk of nipple loss (necrosis) from this type of surgery, either total or partial or the nipple may be disconnected at the time of surgery and reattached (i.e., free nipple)

  Altered nipple sensation; 1 in 5 people approximately. The operation disrupts some of the sensory nerves to the nipple. This can be in the form of reduced nipple sensation and reaction to cold or stimulation, numbness, or heightened nipple sensation. 

• Fat necrosis: This is where the gland of the breast has been re-shaped and this has disrupted the blood supply to some of the fat cells, which causes the fat to become hard and feel like a lump. If you feel a lump following surgery, please report it but usually with imaging +/- biopsy you can be reassured. 

• The need for further treatment: Therapeutic Mammoplasty usually requires post-operative radiotherapy to prevent the breast cancer coming back. There is also a chance you may need chemotherapy and other drug treatments which the oncologist will discuss with you. 

• Cosmetic dissatisfaction and breast asymmetry: This can be discussed at your follow up appointment and further surgery may be available.  

What to expect after the operation

You will need to take regular over the counter painkillers following surgery. You may experience some shooting pains in the breast; these will ease over the next few months. The breasts will be swollen, bruised and painful. The swelling and bruising generally subsides after 4-6 weeks but can take 6-12 months for the scars and shape of the breasts to settle. 

Wound care

• You will have a dressing in place, and we will arrange an appointment for this to be removed after one week. The surgeon may decide to use a PICO dressing. This is a dressing with a small battery pump which provides suction to the wound to promote wound healing. 

• You may have a drain inserted.

• The stitches are dissolvable and do not need to be removed.

• If there is any swelling or discharge from your wound, please inform your Breast Care Nurse for advice. 

• You may feel numbness and tightness around the wound; this is part of the normal healing process. 

• If you feel unwell with a temperature, vomiting or notice significant redness of the skin on or around the breasts you should contact your Breast Care Nurse ASAP to review wound as you may have an infection. Out of hours please contact 111 or present to the emergency department.

Bras and prosthesis

• You need to wear a supportive non-wired bra immediately after the operation, for 4-6 weeks day and night. This helps prevent the weight of the breasts pulling on the wounds and affecting the healing process. 

• If there is a significant difference in size you may want to wear a partial prosthesis in your bra, this can be discussed with your breast care nurse. 

Resuming normal activities

• The length of time you need to take off work depends on the nature of your job but you will need at least 2-4 weeks. 

• You are advised to avoid strenuous exercise for a minimum of six weeks. 

• You are advised not to drive for up to four weeks following surgery and only when you can safely perform an emergency stop. 

•  Avoid heavy lifting, including hoovering and carrying heavy shopping. 

•  We advise for you to stop smoking prior to your surgery and in the post operative recovery period. Smoking increases the risk of complications.

Follow up treatment 

• You will be seen 1 week after your operation with a breast care nurse to remove your dressing and review the wound.

• You will be seen on the Primrose Unit approx. 3 weeks after your surgery to review the surgery and discuss your results and additional treatment you may require. Your case will have been discussed at the weekly Multi-Disciplinary Meeting (MDT).

If you have any concerns, you can contact the breast care nurses on 01752 431898 and they can arrange an appointment if needed. This includes if you have cosmetic concerns, or you would like to be seen by your breast surgeon again for consideration of symmetrising breast surgery.