wide local excision (lumpectomy) with FLAP reconstruction

These oncoplastic techniques integrate cancer removal and aesthetic repair in one step, maintaining breast shape while ensuring complete tumour excision.

What Is Wide Local Excision & Lumpectomy with Flap Reconstruction?

Wide local excision, also known as lumpectomy or breast-conserving surgery, involves removing a tumour with a rim of healthy tissue to ensure clean margins. When a large volume of tissue is removed, the breast can become visibly deformed. In such cases, reconstructive surgery using local perforator flaps (LICAP, LTAP, AICAP, MICAP, Angel Flap) reposition chest-wall tissue at the edge of the breast to fill the defect immediately during the same operation.

These oncoplastic techniques integrate cancer removal and aesthetic repair in one step, maintaining breast shape while ensuring complete tumour excision.

Who Is a Candidate?

Ideal candidates are:

Women with early-stage breast cancer (DCIS, Stage I or II; occasionally Stage III if large breasts and no spread)
Patients with small or medium breasts where therapeutic mammoplasty is not possible
Patients who are fit for postoperative radiotherapy (unless contraindicated, e.g. connective tissue disease, prior breast irradiation, pregnancy)
Patients for whom preserving the breast is a priority, but where simple lumpectomy would cause a noticeable deformity

Types of Flap & Procedure Steps

Surgical Options

Procedure Overview

Tumour removal (wide local excision) with margin assessment
Sentinel‑node biopsy or axillary sampling through the same incision if possible
Raising the local perforator flap (often via lateral or intercostal vessels)
Rotating and securing tissue to fill the excision defect
Closure and symmetry adjustments; potential contra‑lateral breast surgery may rarely be required later for balance

Patient journey

Stage	What Happens
Pre‑op	Imaging, tumour localisation (wire or seed), medical assessment, surgical planning. Fasting instructions and discussion with breast care team
Day of surgery	Under general anaesthetic, tumour removed and flap reconstruction performed in same session – procedure usually 2 hours depending on complexity
Hospital stay	Typically same day discharge or overnight stay; pain managed via analgesia
Weeks 1–2	Dressings in place; drains are not typically used; some mild swelling and bruising
Weeks 3–6	Gradual return to light activity; scar and flap settle; full recovery often at 6 weeks
Later	Radiotherapy usually begins 6-8 weeks post-op; symmetry surgery (lift or reduction on the other breast) may follow after cancer treatment ends (often ~1 year later)

Mr Milligan and his team will guide you through every stage of healing, with post-operative support and tailored aftercare.

Frequently Asked Questions (FAQ)

It preserves most of the breast while ensuring oncologically safe margins. If a flap prevents deformity, a mastectomy may be avoided with equivalent long-term survival for early-stage cancers.

Local perforator flaps involve skin and fat, but not muscle, so arm and chest wall function are preserved. You’ll have incisions at the edge of the breast/donor site but these fade and are hidden in natural folds.

Most patients are discharged the day of surgery or stay in hospital overnight; full recovery is typically six weeks; radiotherapy afterwards may prolong the overall journey.

As with any surgery: infection, bleeding, flap loss, delayed healing. Radiotherapy may affect cosmetic outcome long‑term.

Re‑excision may be needed. If a clear margin cannot be achieved, a mastectomy may be recommended.

Yes. To achieve balance, a breast reduction, lift, or fat transfer may be offered simultaneously or after recovery, often after the effects of radiotherapy are known.

Book Your Private Consultation

If you’re considering a Wide Local Excision & Lumpectomy in Newcastle or Gateshead, book a consultation with Mr Milligan to explore your options and receive a personalised treatment plan.

Wide Local Excision & Lumpectomy with Flap Reconstruction