Preventing Bird’s Beak Deformity: A narrative review of Innovations in Oncoplastic Surgery

Background: In the field of breast surgery, breast conserving surgery (BCS) is widely valued for its ability to preserve the breast while also achieving cosmetically acceptable outcomes and an overall survival rate comparable to that of total mastectomy. However, BCS has not always managed to achieved satisfactory cosmetic results. Among its challenges is the “bird’s beak” deformity, which is characterized by skin retraction and a downward deviation of the nipple areolar complex due to tissue excision from the lower pole of the breast. Methods: Various forms of oncoplastic surgery (OPS) have been developed to prevent bird’s beak deformity. These include volume displacement operations (such as superior pedicle mammoplasty, rotation technique and downward-mobilization procedure), as well as volume replacement techniques, including the latissimus dorsi mini-flap, thoracodorsal artery perforator flap, lateral intercostal artery perforator flap, anterior intercostal artery perforator flap, inframammary adipofascial flap and lipofilling. Conclusion: Choosing the most suitable approach for OPS requires careful consideration of various factors, notably the defect’s size and location, the size of the breast, and the thickness of subcutaneous fatty tissue. Further studies are required to firmly position these forms of OPS techniques in an evidence-based framework.