ROUTINE BREAST SURGERY

• BREAST CONSERVATION/LUMPECTOMY = WIDE LOCAL EXCISION(Palpable, Wire-guided) – excision of cancerous lump with a rim of normal tissue to achieve cancer clearance. This preserves remaining healthy breast and normally is followed by radiotherapy to the whole breast to be as effective as mastectomy
• MASTECTOMY (Simple, Skin Sparing, Nipple Sparing, Goldilocks) – removal of the whole breast when even with advanced oncoplastic surgery (as detailed below), saving the breast is not possible. Usually, immediate breast reconstruction is an option
• SENTINEL NODE BIOPSY – when at cancer diagnosis, armpit lymph nodes appear normal on ultrasound, confirmatory laboratory testing of any spread beyond the boundaries of the breast via commonest route is by removal of few armpit lymph nodes using nuclear medicine chemical or a blue colour chemical. This is usually performed at the same time as breast cancer surgery
• AXILLARY DISSECTION – removal of all armpit lymph nodes when they are proven to contain cancer cells at the same time as diagnosis of breast cancer
• BENIGN PROBLEM OPERATIONS = Lump excision (such as Fibroadenoma), nipple duct surgery (Microdochectomy, Total Duct Excisions) for nipple discharges or inverted nipple correction

ADVANCED ONCOPLASTIC BREAST CONSERVATION SURGERY 

• MAMMAPLASTY – Therapeutic (Wise-pattern, Vertical Scar, Batwing, Melon Slice) – Using a variety of skin patterns to achieve clearance of larger cancers in medium to large breasts by combining with breast reduction (smaller)
• MASTOPEXY -Therapeutic – Using a variety of skin patterns to achieve clearance of larger cancers in droopy medium to large breasts by combining with breast lift (skin tightening to correct breast droop) 
• PARTIAL BREAST RECONSTRUCTION with Perforator flaps -TDAP/LTAP/LiCAP/AiCAP – Using spare side chest wall tissue based on small blood vessels to fill in the defect following excision of larger breast cancers in smaller breasts to avoid mastectomy
• FAT MODELLING – Using fat cells from patient’s abdominal wall or thigh to inject into defect following non-oncoplastic breast conserving surgery especially after radiotherapy

SYMMETRISING SURGERY 

• AUGMENTATION (implant) – Using an implant to increase the size of the other breast to match reconstructed breast or breast augmentation (increase) both sides to achieve cosmesis
• REDUCTION (Wise-pattern, Vertical Scar) – Using a variety of skin patterns to achieve breast reduction (smaller) surgery to match reconstructed breast or reduce both sides

BREAST RECONSTRUCTIONS 

• EXPANDER-IMPLANT reconstruction – Using an implant either alone or combined with ADM (Acellular Dermal Matrix) or own muscle to reconstruct breast after mastectomy
• ADM meshes (Strattice™, Surgimend™) or TiLoop™ based implant reconstruction – Using an ADM, an animal derived mesh to create a hammock to support an implant only breast reconstruction
• LD flap (Immediate + Delayed) – Using the LD (Latissimus Dorsi – back muscle) to reconstruct breast following mastectomy combined with or without an implant
• TDAP only breast reconstruction – Using spare side chest wall tissue based on small blood vessels to build small breasts following mastectomy
• GOLDILOCKS MASTECTOMY RECONSTRUCTION – An innovative method of reconstructing a breast using patient’s own skin only
• FAT GRAFTING only breast reconstruction – Using fat cells from patient’s abdominal wall or thigh to graft to build small breasts following mastectomy
• NIPPLE RECONSTRUCTION – Using a variety of skin patterns to reconstruct nipple followed by tattoo to match with other side or a colour of patient’s choice