To understand the cosmetic principles behind the two new different approaches, a description of the conventional/standard breast conserving treatment is necessary. The goal of the surgery is to remove the tumor and marginal tissue while damaging the breast as little as possible. However, the surgeon needs to remove enough testable tissue to determine if the cancer is limited to the tumor itself or if the cancer has spread. The surgeon makes an incision over the targeted malignancy or around the areola if the tumor is accessible from that site, and cuts out the tumor, along with a small layer of tissue surrounding the tumor.
Illustration 1 [A].
Illustration 2 [B].
Volume replacement techniques will be more suited to women who do not desire surgery to the opposite breast and who have a large tumor compared to breast volume.
Breast conserving surgery and partial breast reconstruction can be carried out either simultaneously as a one-stage procedure, or using a two-stage approach. Although patients prefer a one-stage procedure, it requires confirmation of complete tumor excision using frozen-section analysis during surgery. The frozen section procedure is a pathological laboratory procedure to perform rapid microscopic analysis of a specimen and the principal use of the frozen section procedure is the examination of tissue while surgery is taking place.
Illustration 3 [C].: Local flap transferred. Original blood supply is maintained (known as pedicled flap)
Illustration 4 [D].: Flap where original blood supply is not maintained (known as free flap)
Many surgeons and breast care nurses recommend the use of a post-op bra after both conventional/standard breast conserving surgery as well as after volume displacement and volume replacement surgery, as the bra offers the very important support, fixation and stabilisation of the treated breast.
A post-op bra will also hold dressings in place after surgery, reducing dressing change frequency, which again reduces infection risk.
To accommodate the insertion of drains, the bra fabric and the underbust band are both made of soft and flexible fabric. Furthermore, loop bands placed at the ribbon band of the bra (like e.g. the Carefix Marianne bra) will help fixate the drainage bulbs to avoid any uncomfortable dragging of drain tubes and it will ease the handling of the entire drainage system.
The functional purpose of post-op bras is to create hemostasis and reduction of edema to minimise infection risk and speed up the healing process in general. In this way, the post-op bra supports the surgical outcome. It may vary from surgeon to surgeon how much compression is preferred. The level of compression can always be regulated through the choice of size.
Some post-op bras are pocketed and hence double-layered, which again provides improved compression and fixation as well as the option to wear lightweight textile puffs. A bra and a loose textile puff bring comfort and improve the body image, by giving the body an aesthetic and symmetric appearance in case of asymmetry.
The support from a post-op bra may also reduce post-surgical pain and soreness of the sensitive skin and underlying structures, making recovery more comfortable.
As a post-op bra offers protection, the woman may feel more safe, particularly when she regains mobility shortly after surgery.
If the post-op bra features a high back, it will help prevent strains and pains in the neck, shoulders and the upper back by adding support to help the woman maintain normal body posture (posture correction).
Typically, the bra is worn for a minimum of 6-8 weeks after breast conserving surgery. The bra has to be worn both day and night for the first weeks. Subsequently, the bra can be worn only in daytime.
Our Carefix assortment of seamless post-op bras accommodates all the above criteria and offers a perfect choice of post-op bra after all types of breast cancer surgery. To assess and validate our range of post-op bras and accessories suitable for both conventional/standard breast conserving surgery, volume displacement and volume replacement, click the photos below.
|Lisa art.no. 3471||Mary, art.no. 3343||Marianne, art.no.3373||Anna, art.no.3270||Breast puffs, art.no.8108|
[C].Illustration 3: https://advancedreconstructivesurgery.com/restorative-techniques/perforator-flap-reconstruction/flap-procedures/tdap-flap
[D].Illustration 4: https://www.drhayduke.com/breastreconstructionaftermastectomy/