Lateral intercostal artery perforator flap breast reconstruction (LICAP) aims to restore the size and shape of your breast by replacing lost breast tissue from the cancer surgery with skin and fat taken from the side of your chest wall and back. Muscle is not removed during this procedure therefore causing no affect to your arm or chest wall function.
Women choose to have this surgery as it allows for the appearance of a natural breast avoiding the need for a full breast reconstruction. Following this surgical procedure, you can expect to stay 1-2 nights in hospital.
Why you might need it
If you’ve been diagnosed with breast cancer, we can help. We understand how hard cancer is on both your body and mental health – and right now all you probably want is to get back to some kind of normal life.
Traditionally, if you have a large tumour it would require a mastectomy with breast reconstruction. However, if your cancer is on the outer part of your breast occupying a quarter of your breast volume, you may be suitable for a LICAP thus avoiding the need for a mastectomy. Removal of such a large cancer leaves a large defect causing asymmetry. By choosing to have LICAP, this defect can be reconstructed at the time of your surgery to restore the size and shape, leaving you with a natural looking breast.
Find a Spire hospital offering this treatment
Who will do it?
Our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals. They have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many consultants have international reputations for their research in their specialised field.
Before your treatment
You have a formal consultation with a consultant or other healthcare professional. During this time, you can explain your medical history, symptoms and raise any concerns that you might have. We also discuss with you if any further diagnostic tests, like as scans or blood tests, are needed, and let you know if there are additional before we do them.
Preparing for your treatment
Our dedicated team provide tailored advice to follow in the run up to your visit. And we aim to make your experience with us as easy and relaxed as possible.
Visit patient information for our visiting hours, food, what to pack if you're staying with us, parking and all the other important practicalities.
The procedure
On the morning of your surgery, your consultant will draw markings on your skin to show where the incisions will be made. Your consultant will need to map out the underlying blood vessels to ensure a good blood supply to the flap being used to fill the defect in your breast- this will be done by using a hand held Doppler.
A photograph may be taken from the neck down before and after your surgery for records and comparison. Your consultant will ask you to sign a consent form to show you are happy with this. This will remain anonymous and will be discussed prior to your surgery date.
The operation takes approximately 3 hours. Once your tumour has been removed, your surgeon will use the tissue from the side of your chest wall and back to reconstruct the space left in your breast. If you require lymph node surgery this will be performed through the same scar thus leaving you with no scars on your breast (unless your underlying cancer is close to the skin needing skin to be removed from the breast). Your consultant will discuss with you whether you need Lymph node surgery.
You will be left with a long scar on the side of your chest going towards your back. Over time, this often fades and is mostly hidden under your arm and bra strap.
You do not routinely need drains after this procedure unless it is combined with Axillary Lymph Node clearance. Drains are used to allow serous fluid to drain from the surgery site, to keep you comfortable. Your consultant will explain this to you.
Aftercare
LICAP breast reconstruction requires you to stay in hospital for 1-2 nights.
After the procedure, you will be taken from the operating theatre to a recovery room, where you will come round from the anaesthesia under close supervision.
After this, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you’re ready to go home.
On discharge, you will be given advice on wound care; provided with analgesic medication (if required); advised on when you will need to be seen for a follow-up and given a contact phone number for the hospital in case you need any further advice.
Follow ups
Even after you’ve left hospital, we’re still looking after you every step of the way. After a LICAP breast reconstruction we’ll typically want to see you at 1-2 weeks after to see how you are doing. At this consultation, your consultant will be able to discuss the final histology results and go through the rest of your cancer treatment. This may be a combination of chemotherapy, radiotherapy and anti-hormone tablets depending on the type of cancer. This will have been reviewed by the multidisciplinary team to ensure the best treatment is provided for each individual patient.
On rare occasions, complications following LICAP breast reconstruction can occur. If you experience any of these symptoms, please call us straightaway:
- Bleeding / infection causing pain and swelling
- Blood clots in legs and lungs (Deep vein thrombosis & Pulmonary Embolism)
Others include:
- Seroma (a build up of fluid where tissue has been removed, often occurring after surgery)
- Wound breakdown
- Flap failure
- Tightness in scar
- Altered sensation
- Shoulder stiffness
- Keloid scarring
- Outcome not achieved / asymmetry
If you have any questions or concerns, we're here to help. Your consultant will discuss post-surgery complications and what to do.
Pain relief
If you need them, continue taking painkillers as advised by the hospital.
Recovery time
The usual recovery period for this procedure is 3-4 weeks. Your scar may feel tight but should relax after a few weeks. A physiotherapist will give you some gentle exercises to perform at home which are vital to ensure you regain full shoulder movement.
You will need to wear a soft breast support for the first week and then a soft, non-wired bra will be suitable for the following 3-4 weeks.
You will need to sleep on your back for the first 2 weeks. It is advised that you refrain from driving for the first 2 weeks and normal strenuous activities can be resumed gradually from 6 weeks.
End results
Post-surgery, you will have normal looking breasts with scars hidden below the breast and on the side of your chest wall. Do expect some degree of asymmetry as no two breasts are exactly the same. You may feel tightness in the scar but should not be a problem if you follow physiotherapy advice.
How your loved ones can help
Once you’re ready to be discharged from hospital, you’ll need to arrange a taxi, friend or family member to take you home as you won’t be able to drive.
Why choose Spire?
We’re committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results.
Important to note
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.