Breast cancer is treated via lumpectomy at the same time as the reconstruction--meaning immediate, life-changing results and a shorter, easier recovery period.
With oncoplasty, the focus is on conserving the breast while also defeating the cancer. This allows Dr. Savalia to achieve very natural, well-shaped breasts that look as good or even better than before surgery.
Oncoplasty is performed as an extremely coordinated approach between an experienced and qualified breast cancer team of oncologists, radiologists, pathologists, and a board certified plastic surgeon like Dr. Savalia
To help you understand the option of my method of oncoplastic breast reconstruction, I have put together, in a fairly comprehensive way, the most-asked questions that my patients have posed to me over the years. If I can be of support, I would welcome seeing you for a consultation to assess and discuss your particular situation and share my opinion as to the best course of action for you to take.
Oncoplastic breast reconstruction combines treatment of cancer with a plastic surgery technique to immediately reshape the remaining breast tissue and achieve a more satisfying breast appearance following lumpectomy surgery.
Oncoplastic breast conservation represents an entirely new philosophy in breast reconstruction that places increased importance on how a woman feels about the appearance of her breasts after surgery. It requires a coordinated approach with a team of medical professionals including a plastic surgeon, surgical oncologist, medical oncologist, radiation oncologist, radiologist, and pathologist.
In my experience performing this procedure, oncoplastic breast reconstruction techniques will allow a woman to have breasts that look as good as, or even better than, they did before surgery. In every case, the surgery is designed to remove cancer cells as completely as any other breast cancer surgery technique.
It is my belief that many women are subjected to mastectomy without true necessity. My goal is to offer patients who qualify for lumpectomies, a treatment on par with mastectomy in terms of survival–but superior in terms of quality of life.
A bit of history. When lumpectomies started to become a viable alternative to mastectomy, many patients were offered breast conservation as an option. The initial breast appearance after this was often quite good, and patients and doctors were happy.
It was not until later, after radiation therapy, that the true results of a lumpectomy started to become apparent. When the tumors were small in comparison to the entire breast, and in favorable locations, the breast shape and appearance was usually preserved. However, when lumpectomies were performed for tumors that were relatively larger compared to the breast or for tumors that were in unfavorable locations in the breast, the breast often appeared misshapen, indented, and smaller than the opposite breast. This unanticipated result, after radiation, is often extremely difficult to correct.
In response, I have developed a unique technique in oncoplastic surgery, which combine oncology surgery and plastic surgery to offer an alternative to traditional mastectomy or lumpectomy. Oncoplastic surgery is a form of immediate reconstruction that is designed to conserve as much breast tissue as possible while also aggressively removing all of the cancerous tissue.
Since the cancer removal and reconstruction are done at the same time, the vast majority of my patients have all of their surgical treatment completed in one step, with a shorter recovery as compared to mastectomy and reconstruction, and return to life within a few weeks. By combining the reconstruction with the lumpectomy procedure, I am able to preserve the breast shape and minimize any deformity of the breast. In addition, the opposite breast can be reshaped at the same time if desired, to maintain symmetry.
The recovery is similar to lumpectomy surgery. Driving by one week. Back to work by two weeks. Full activity by four weeks. This is opposed to 8-12 week recovery with other methods.
Here is a summary of the benefits of single surgery oncoplasty vs breast removal with a mastectomy:
No, the goal is not to use an implant in either breast. This will help avoid complications associated with breast implants and radiation therapy.
Women who qualify for lumpectomy should know all their options before proceeding but they should do it quickly since they are on a short timeline. Most surgeons make offer a form of “oncoplastic surgery,” but it is often not the more complex version that we offer.
This is true in many cases – if you simply remove a large part of a breast and don’t do anything to reshape the breast afterward, of course, the breast will heal with a large indentation. But this can be avoided if the breast is immediately reshaped to accommodate for the loss of tissue due to a lumpectomy through oncoplastic surgery.
Let me say first, that health is always the major determinant for any procedure I recommend. In many cases, you simply do not need to make this tradeoff if you choose oncoplastic breast reconstruction. I am a specialist in this procedure, which saves more breast tissue for a better cosmetic outcome while thoroughly and completely removing cancerous tissue. With oncoplastic breast reconstruction, a woman can have both a healthy body and a beautiful one she is proud of.
Oncoplastic breast conservation can be combined with intraoperative radiation therapy (IORT) for select low-risk patients. Our team has treated over 1000 patients with invasive and noninvasive breast tumors 30 mm or less in total size. What this means is that real-time radiation therapy can replace the need for follow-up radiation treatments after surgery. Women are able to begin the healing process after surgery without the hassle and inconvenience of post-surgical radiation appointments. Our radiation oncologists can tell you more about whether you are a candidate for IORT after reviewing your case in detail with our breast cancer surgeons.
Oncoplastic breast conservation procedures are covered just like other more traditional breast reconstruction techniques. My office can help you with the authorizations you will need prior to surgery to maximize your insurance coverage for the procedure.
No. For the woman who qualifies for lumpectomy, oncoplastic breast reconstruction can often be the best option. Those who do not qualify may be better candidates for mastectomy and traditional reconstruction.
It is an advanced concept that is difficult to explain without context. Even most doctors do not know about it, because it is so specialized.
Surgeons used to say “we’ll work on the other breast later.” That is not my approach. We can balance the breasts all in the same operation so the outcome is a natural-looking, beautiful one. Sometimes that requires reducing the size of the other breast or reshaping it.
With traditional lumpectomies, the re-excision rate ranges from 20 to 30 percent. With oncoplasty, our rate is as low as two percent.
As mentioned earlier, oncoplastic breast reconstruction requires a coordinated approach with a team of medical professionals including a plastic surgeon, surgical oncologist, medical oncologist, radiation oncologist, radiologist, and pathologist. I have been working with the same, highly-respected, talented team members for many years, and we are all very proud of what we are able to achieve for women.
Our practice makes it easy to travel to Southern California for your breast cancer treatment and specialized breast reconstruction. To assist you, we offer a travel assistance program to guide you in arranging flights and a hotel stay. Patients can return home in 1-2 weeks. Their medical oncologist at home can take over care at that point.
Many of your pre-surgical tests can be performed locally, in your home city, by your personal physician. We can then coordinate with your physician to get the information and test results we need prior to surgery. This allows you to make a shorter trip and return home sooner. Besides helping to ensure that your trip is as brief as possible, we would also like it to be as comfortable as possible.
While Dr. Savalia specializes in breast-sparing oncoplastic breast reconstruction, he understands that every woman’s situation is unique and requires a personalized approach. He will meet with you individually to discuss your options and choose the right procedure for your breast reconstruction. Dr. Savalia can help restore the breasts through a variety of reconstructive methods, including oncoplasty and mastectomy options.Learn More
If you have questions about breast reconstruction, my staff and I are happy to help. By working with a team of Southern California's most experienced breast reconstruction surgeons, radiologists, and nurses, we are able to provide women with the best possible options for one of the most life-changing and rewarding surgeries. Please contact us online or call (949) 759-0980 for more information.
Dr. Savalia is known for the most innovative, advanced breast reconstruction techniques. He is a board certified plastic surgeon and artist who creates the most natural, elegant, personalized aesthetic results. He is as renown for his care and compassion as he is for extraordinary outcomes. This is why he was named one of Orange County’s Physicians of Excellence by his peers.
Dr. Savalia’s Breast Health Center team includes the finest oncologists, radiation specialists, geneticists, and nurse navigators. Being cared for by an established team is a great advantage for patients.
"I prefer a light-handed approach that leaves my patients looking visibly rejuvenated, not surgically enhanced."