depression
At the site of the operation, the breast is retracted, a step or pit is visible.
CONDITION / BREAST
Breast deformation after lumpectomy.
Deformation of the breast after organ-sparing surgery is a depression, asymmetry or compaction that remains after the removal of a part of the breast with a tumor and radiation. The shape is restored with own fat, tissue flaps and correction of the second breast — when the oncology plan allows it.
CONCEPTUAL VISUALIZATION- What it is
- Depression, asymmetry, displacement of the nipple or induration after removal of part of the breast and radiation.
- Why
- There is less tissue, and radiation can tighten and tighten them over time.
- What is being corrected?
- Own fat, flaps of tissue nearby, correction of the second breast.
- Who treats it
- The surgeon restores the form; tumor treatment and supervision is conducted by an oncologist.
01 / WHAT IS ITWhat is
What is
deformity after lumpectomy.
Organ-sparing surgery is when not the entire breast is removed, but only the area with the tumor. Depending on the volume, it is called lumpectomy, quadrantectomy or sectorial resection. After surgery, radiation may be given to reduce the risk of the cancer returning.
Breasts are preserved, but their shape may change. A depression or a retracted scar appears at the site of the operation, the nipple shifts toward the scar, one breast becomes smaller than the other. A review of 18 studies noted that organ-sparing surgery can often result in an unsatisfactory breast appearance.
Irradiation works separately. Tissue compaction (fibrosis) is a well-known late consequence of such treatment: breasts may tighten, become asymmetrical, and hurt. In a study of 775 women (median follow-up 4 years), moderate or severe fibrosis and worse breast appearance were associated with worse quality of life.
The purpose of the correction is to restore volume and contour, align the breasts with each other and soften the tissues. Correction can be planned even after the end of treatment — this is a delayed recovery; the plan is always coordinated with the oncologist.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow they change
How they change
chest
The consequences depend on how much tissue was removed, where the tumor was, and whether radiation was used.
Asymmetry
The operated breast became smaller, higher or of a different shape than the other.
Displaced nipple
The nipple and areola are pulled in the direction of the scar or look away.
Deformation of the nipple and areolaSealing after irradiation
The skin and tissues of the chest are tight, tightened, the chest may hurt.
Retracted scar
The scar adheres to the tissues underneath and pulls on the skin.
Cicatricial deformation of the bodyInconvenience
It is difficult to choose underwear, the woman avoids the mirror and undressing. You should tell your doctor about it.
03 / REASONSIt depends on what
It depends on what
breast appearance
The appearance after organ-preserving surgery is determined not only by the surgery itself.
Breast size and tumors
When four reconstructive surgeons evaluated the breasts of 109 women after such treatment, the risk of a worse appearance was higher with larger breasts and larger tumors.
Axillary lymph nodes
In the same study, a worse appearance was also associated with removal of axillary lymph nodes.
Irradiation
In a meta-analysis of lipofilling, it was radiation therapy that was the most important factor on which the number of sessions and the frequency of complications depended.
Operation technique
Plastic surgery techniques at the time of tumor removal may provide a better breast appearance, although the quality of these data is low.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Deformation that appeared months or years after surgery and radiation is a planned situation: it usually does not require emergency care. But after any breast surgery, including corrective surgery, some symptoms require immediate help.
103 immediately if:
- suddenly it is very difficult to breathe;
- pain in the chest or upper back;
- the heart beats very fast;
- the person fainted;
- confusion, slurred speech;
- very frequent breathing;
- bluish, pale or mottled skin;
- very high or very low temperature, chills or shivering;
- a rash that does not go away when pressed.
Do not delay a visit to the doctor:
Immediately - to the surgeon who operated; if it is not possible to contact - to the reception department: bleeding from the wound; sudden or increasing pain or swelling in the area of the operation, the breasts quickly increase in size and become tight; suddenly numb hand; cough with blood; pain and swelling in the calf or arm. On the same day: the wound turned red, became hot, pus flows from it. In the coming days - to the oncologist, without waiting for a routine examination: a new lump or swelling in the breast or armpit; the skin of the breast has retracted or has become like an orange peel; the nipple retracted or a rash appeared on it; discharge from the nipple. Planned: depression, asymmetry, compaction after healing and completion of irradiation.
05 / DIAGNOSTICSAs defined,
As defined,
what to fix
- Documents
Surgery report, histology, radiation data, recent mammography or ultrasound.
- Review
The volume and shape of both breasts, the position of the nipples, scars, how dense the tissues are after radiation.
- Photo in standard angles
For planning and to compare the result over time.
- Coordination with the oncologist
Is the treatment completed, what tests and examinations are needed next, or can correction be started?
06 / TREATMENTHow to fix
How to fix
breast shape
The method is selected according to the size of the defect, the condition of the tissues after irradiation, the size of the breast and the wishes of the woman. Research has not yet determined the optimal method of correction after organ-sparing treatment, so the plan is made individually.
01
During tumor removal
So that there was less deformation.
- Oncoplasty
- The tumor is removed, and in the same operation, breast tissue is redistributed using plastic surgery techniques. British guidelines call such operations the standard of care for breast cancer.
- What is known
- In a Cochrane review (78 studies, 178,813 women), oncoplasty was found to be no worse than conventional surgery for cancer recurrence; may have required re-extraction less frequently, but may have resulted in more complications. The reliability of these data is very low.
- Oncoplastic reduction
- The tumor is removed together with breast reduction. In a review of 2,711 such operations, complications were 20%.
02
When the deformation is already there
After completion of treatment.
- Lipofilling
- Own fat, taken by liposuction, is injected into the cavity. According to a meta-analysis of 21 studies, after organ-sparing surgery, an average of 1.72 sessions is required to complete the correction. The number of sessions depended most on exposure.
- Lipofilling after radiation
- In a review of 17 studies, 72 of 1040 women (6.9%) had complications after lipofilling in irradiated breasts, and 970 of 1040 (93.3%) were satisfied with the result.
- Flaps from the chest wall
- Skin and fat from the adjacent chest wall are moved into the defect on the vascular pedicle without affecting the muscles. In a meta-analysis of 1893 such flaps, complications in the area of the flap were in 13%, the flap did not take root in 1%.
- Other flaps
- A latissimus dorsi flap is also used: in a review of 40 studies, it was used most often along with chest wall flaps.
- Second breast
- To straighten the breast, the second one is adjusted - most often it is reduced. In a study of 109 women, surgeons recommended correction of the second breast to 73.3% of women with poor-looking breasts.
03
When to adjust the second breast
- Immediately or later
- According to a meta-analysis of 12 studies (2339 women), there was no significant difference in complications and reoperations in general. After organ-sparing surgery, there were fewer immediate aesthetic improvements: 6.6% versus 15.2%. Data are mostly retrospective.
04
Oncological safety
- Lipofilling and relapse
- In a meta-analysis of 11 studies, lipofilling was not associated with more frequent local cancer recurrence, particularly after organ-sparing surgery and radiation.
- Examination
- According to the examination, lipofilling does not significantly interfere with further breast examinations.
- Supervision
- Regular examinations by an oncologist continue even after correction. Show alarming changes without waiting for the next review.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Deformation of the breast after organ-preserving surgery is corrected at the Institute of Surgery of Dr. Valikhnovskyi in the field of "Mammary gland reconstruction". The plan is drawn up together with the oncologist, taking into account the exposure. The clinic is responsible for restoring the shape of the breast; tumor treatment, radiation therapy and oncological supervision are conducted by an oncologist.
CLINIC SERVICE
Breast reconstruction
Breasts after mastectomy - with own tissues, implants or fat, immediately or later.
View service
What we do for this condition
- Lipofilling — own fat, taken by liposuction from other areas, fills the cavity; after organ-sparing surgery, 1–2 sessions are usually required.
- Local patches — tissues from the adjacent area are moved into the defect to restore the volume and contour of the breast.
- Correction of the second breast — the second breast is adjusted for symmetry — often after a few months, when the shape stabilizes.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend breast photo, surgery report and radiation details.
- ConsultationExamination of both breasts, assessment of tissues after radiation; coordination with the oncologist.
- PlanFat, flap or correction of the second breast - separately or combined, how many stages will there be.
- CorrectionLipofilling is often done in several sessions; flaps - a separate operation.
- RecoverySupportive underwear, load restrictions; then - examinations by a surgeon and an oncologist.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Is it possible to correct the breast after radiation?
Yes. But radiation is the most important factor that affects the number of lipofilling sessions and the frequency of complications. This is taken into account when choosing a method.
Does lipofilling increase the risk of cancer returning?
In a meta-analysis of 11 studies, lipofilling was not associated with more frequent local cancer recurrence, particularly after organ-sparing surgery and radiation. Examinations at the oncologist after correction continue.
How many lipofilling sessions will be needed?
After organ-sparing surgery — an average of 1.72 sessions, according to a meta-analysis of 21 studies. Most of all, the number of sessions depends on the exposure.
When can you make a correction?
The treatment of the tumor must be completed first. Experts do not have a single opinion about the optimal time for reconstruction after radiation, so the terms are chosen together with the oncologist.
Maybe it's easier to reduce the second breast?
Sometimes this is enough, sometimes the second breast is adjusted together with lipofilling or a flap of the operated one. The doctor will tell you what will suit you after the examination.
A new lump appeared in the breast. What to do?
Show her to the oncologist in the coming days, without waiting for a routine examination. Not every lump is cancer, but it should be examined.
Sources
18 sources · guideline, Cochrane review, meta-analyses, cohorts and NHSshowCollapse
- Oncoplastic breast surgery: A guide to good practiceEuropean Journal of Surgical Oncology, 2021doi:10.1016/j.ejso.2021.05.006 ↗
- Oncoplastic breast-conserving surgery for women with primary breast cancerCochrane Database of Systematic Reviews, 2021doi:10.1002/14651858.CD013658.pub2 ↗
- International multidisciplinary expert panel consensus on breast reconstruction and radiotherapyBritish Journal of Surgery, 2019doi:10.1002/bjs.11256 ↗
- The association between breast fibrosis, cosmetic outcomes, and long-term health-related quality of life after breast-conserving therapy: a multicenter cross-sectional observational cohort studyThe Breast, 2025doi:10.1016/j.breast.2025.104541 ↗
- Breast-conserving therapy for breast cancer: Cosmetic results and options for delayed reconstructionJournal of Plastic, Reconstructive & Aesthetic Surgery, 2017doi:10.1016/j.bjps.2017.05.005 ↗
- Indications and Controversies in Lipofilling for Partial Breast ReconstructionClinics in Plastic Surgery, 2018doi:10.1016/j.cps.2017.08.008 ↗
- Efficacy of breast reconstruction with fat grafting: A systematic review and meta-analysisJournal of Plastic, Reconstructive & Aesthetic Surgery, 2018doi:10.1016/j.bjps.2018.08.024 ↗
- Safety and Effectiveness of Autologous Fat Grafting after Breast Radiotherapy: A Systematic Review and Meta-AnalysisPlastic & Reconstructive Surgery, 2021doi:10.1097/PRS.0000000000007416 ↗
- Local-regional recurrence risk after autologous fat grafting in breast cancer patients: A systematic review and meta-analysisJournal of Surgical Oncology, 2020doi:10.1002/jso.25829 ↗
- Chest Wall Perforator Flaps in Partial Breast Reconstruction: A Systematic Review and Meta-analysisPlastic and Reconstructive Surgery – Global Open, 2025doi:10.1097/GOX.0000000000006996 ↗
- A systematic review of oncoplastic volume replacement breast surgery: oncological safety and cosmetic outcomeThe Annals of the Royal College of Surgeons of England, 2022doi:10.1308/rcsann.2021.0012 ↗
- Oncoplastic reduction mammoplasty: Systematic review and proportional meta-analysis of surgical outcomesJournal of Plastic, Reconstructive & Aesthetic Surgery, 2024doi:10.1016/j.bjps.2023.11.052 ↗
- Immediate versus delayed symmetrisation of the contralateral breast after oncoplastic procedures: A systematic review and meta-analysisJournal of Plastic, Reconstructive & Aesthetic Surgery, 2026doi:10.1016/j.bjps.2026.01.004 ↗
- MastectomyNHS, 2025nhs.uk/tests-and-treatments/mastectomy ↗
- Pulmonary embolismNHS, 2026nhs.uk/conditions/pulmonary-embolism ↗
- SepsisNHS, 2026nhs.uk/conditions/sepsis ↗
- Symptoms of breast cancer in womenNHS, 2024nhs.uk/conditions/breast-cancer-in-women/symptoms-of-breast-cancer-in-women ↗
- Treatment for breast cancer in womenNHS, 2024nhs.uk/conditions/breast-cancer-in-women/treatment-for-breast-cancer-in-women ↗
The figures on the page are from these sources.
Breasts have changed
after a lumpectomy?
Send breast photo, surgery report and radiation details. The doctor will tell you what can be fixed and when.