ABSTRACT
INTRODUCTION With approximately 30% of women remaining unsatisfied with the cosmetic outcomes of breast-conserving surgery (1) there exists a potential need for breast deformity correction. The causation of deformity and asymmetry is a combination of surgery and radiotherapy. Surgical effects will be more pronounced with large percentage excisions and when resection is performed in “sensitive areas” of the breast (classically central, inferior, and medial excisions). The cosmetic outcomes are notably worse in the medial half of the breast when more than 5% to 10% of breast volume is removed, whereas up to 20% may be excised in the lateral half of the breast before cosmetic outcomes are significantly affected (2). Indeed, it is the percentage of breast excision that is important in relation to risk of deformity and not the absolute size or weight of tissue excised-a small-weight excision may cause significant deformity in a low volume breast (2). By understanding these simple principles about risk of deformity, the surgeon can predict who will benefit from appropriate oncoplastic intervention (3-6) at the time of primary surgery, thus avoiding or minimizing subsequent breast deformity.
