Why oncoplastic surgery rather than conventional surgery?
In conventional breast-conserving surgery, the tumour is removed together with a margin of healthy breast tissue. If the volume resected is significant relative to the size of the breast, or if the tumour lies in a sensitive area, healing can lead to visible defects: skin retraction, deformities or troublesome asymmetry.
The oncoplastic approach changes this perspective:
- The tumour is removed with optimal safety margins.
- The defect left is remodelled immediately, in the same operation.
- The remaining glandular tissue is mobilised to restore the natural curve of the breast, and the incisions are placed strategically, hidden as far as possible in the anatomical folds or around the areola.
- When indicated, the opposite breast can be operated on at the same time or at a later stage, for optimal symmetry.
Who is this procedure for?
Oncoplastic surgery is an excellent option for patients who wish to keep their breast and meet the necessary clinical and oncological criteria.
The treatment decision is personalised and takes into account:
- The ratio between tumour volume and total breast volume
- The location of the lesion in the breast
- The biological characteristics of the tumour and the associated treatments
- The patient’s health and preferences
Types of oncoplastic techniques
Depending on the volume of tissue to be removed and the shape of the breast, oncoplastic techniques fall into two broad categories: volume remodelling techniques (Levels I and II) and volume substitution / replacement techniques.
Limited resections
Recommended when less than 20% of the breast volume is removed. The adjacent glandular tissue is mobilised to fill the defect, without the need for complex repositioning of the areola or excision of excess skin.
Mastopexy/reduction mammoplasty
Indicated for larger resections (20–50%) or in patients with large or ptotic (drooping) breasts. The tumour is removed, the nipple-areola complex is repositioned and the whole gland is remodelled. This usually involves a symmetrisation procedure on the opposite breast.
Replacing the volume with a flap
When the breast’s own volume is small and the resection would leave a visible defect, the remaining space can be filled by bringing in a flap of the patient’s own tissue from nearby.
The patient’s journey: step by step
Consultation and pre-operative assessment
We review the medical history and analyse the mammogram, ultrasound and breast MRI, as well as the result of the breast biopsy.
Surgical plan and localisation
For non-palpable lesions, an image-guided localisation is carried out before surgery (placing a metal wire or a clip/marker) to locate the tumour with millimetre precision.
The operation
It is performed under general anaesthesia. We remove the tumour, assess the axillary lymph nodes (usually by the sentinel node technique) and reshape the breast in the same operation.
Final histopathological examination
The excised specimen is examined under the microscope to check the oncological resection margins.
Complementary treatments
Surgical treatment is completed, in line with oncology guidelines, by adjuvant radiotherapy, together with hormone therapy, chemotherapy or targeted therapies, depending on the biological profile of the tumour.
Risks and particularities
Oncoplastic surgery is a safe procedure, but like any surgical act it carries certain risks:
- Haematomas, seromas (fluid collections) or local infections
- Delayed healing or fat necrosis (cytosteatonecrosis), which can be felt as a firmer, benign area
- Residual asymmetry or changes in sensation of the areola and skin
- The risk of positive margins on histopathological examination, in which case a repeat operation may be needed
Post-operative recovery
- Hospital stay
- In general short (1–3 days), depending on the complexity of the remodelling and on whether drains are needed.
- Support
- Continuous wearing of a medical elastic bra for 4–6 weeks is recommended; it helps reduce swelling and supports the new shape of the breast.
- Physical activity
- Avoid strenuous effort, heavy lifting and sudden movements of the arm on the operated side for at least a month.
- Follow-up
- You will return for regular check-ups for wound care, removal of sutures and monitoring of healing.
When to contact your doctor urgently
Contact the surgical team immediately if you notice:
- Fever (above 38°C) or chills
- Rapid, painful, tense swelling of the breast
- Marked redness, local warmth or discharge at the incision
- Severe pain that does not respond to the recommended painkillers
- Dehiscence (opening) of the wound edges
For major emergencies or difficulty breathing, call 112 immediately.
Frequently asked questions
Will I have visible scars?
Every surgical incision leaves a scar. In oncoplastic surgery, we plan the cuts so that they follow the natural folds (under the breast, around the areola) or the skin tension lines. Over time, with proper care, they mature and become discreet.
Will radiotherapy spoil the aesthetic result?
Radiotherapy is essential after breast-conserving surgery to minimise the risk of local recurrence. Radiation can cause slight retraction, fibrosis or late asymmetry of the breast, but modern targeted radiotherapy techniques and a correct initial oncoplastic remodelling greatly minimise this effect.
Is the healthy breast always operated on too?
Not always. With Level I techniques (minor remodelling), it is often not necessary. With Level II techniques, symmetrisation of the opposite breast is often recommended for a harmonious, balanced aesthetic result, either in the same session or after the oncological treatments are completed.
What happens if the resection margins are not clear?
If histopathological examination shows tumour cells at the edge of the excised specimen, a repeat operation is needed – either a re-excision to widen the margins or, if the remaining space no longer allows the breast to be conserved, conversion to a mastectomy (which can be combined with reconstruction).
Want to talk about your situation?
Every case is different. At the consultation we go through the options together.
Medically reviewed by Dr. Răzvan Andrei. Last updated: 1 October 2026.