Intraoperative physiotherapeutic approach in oncoplastic surgery: case report

Introduction: Fat grafting is a very useful technique in partial and total breast reconstructions. In this technique, where adipose tissue is liposuctioned and purified, it is injected into the breast tissue or thoracic wall to correct deformities or due to its regenerative effect on the skin, improving elasticity and reducing the risk of capsular contracture and rippling. The donor region may experience pain, swelling, and bruising, natural events of inflammation. Normally, mechanical compression is applied, such as a surgical shaper, but the importance of physiotherapeutic action in the recovery process deserves further study. Methodology: Ethical Aspects: The patient signed an informed consent form for the presentation and publication of the Case Report. Case Report: Patient L.M.R.M, female, 68 years old, underwent mastectomy and axillary clearance and immediate reconstruction with an expander on the left side, in January 2022. The anatomopathological study showed classic lobular carcinoma, grade 1, 3.2 cm, 7/24 lymph nodes, and TNM classification pT2pN2M0 IIIb. Luminal B. She finished chemotherapy and, soon after, 15 sessions of radiotherapy. She underwent a second surgical approach in 2023, Liposuction 480 mL lipofilling, exchange for an extra high projection anatomical implant, and on the right breast, augmentation mammoplasty and mastopexy. She uses letrozole and aprazolam. Results: Physiotherapy Approach: Because it is mature skin, concerning the aesthetic and functional appearance of the abdominal region, as the donor region, adhesive elastic bandages were applied intraoperatively with the aim of reducing pain, containing swelling, tissue alignment, favoring skin retraction, absorbing bruises, and preventing fibrosis. The patient received 3 weekly physiotherapy sessions after the removal of the bandages, on the seventh postoperative day. During the sessions, the approach was through manual therapies and kinesiotherapy. Conclusion: We believe that physiotherapy helps the patient resume her daily life activities with functionality and a better quality of life, as happens in aesthetic plastic surgeries.