When Should I Have Breast Reconstruction?
Immediate vs. delayed reconstruction
Breast reconstruction surgery can be performed any time following mastectomy. Some women have breast reconstruction at the same time as mastectomy (immediate reconstruction), while others wait several weeks, months or even years after mastectomy (delayed reconstruction). The “right” time for you to have breast reconstruction will depend on a number of factors, including:
- Breast cancer stage
- Your overall health
- Additional therapies needed to treat the breast cancer (i.e., radiation or chemotherapy)
- Your personal preference
- Your lifestyle
Ultimately, timing your breast reconstruction is a decision to be made between you, the doctors treating your cancer, and your breast reconstruction surgeon.
Breast reconstruction performed at the same time as mastectomy is called immediate reconstruction. The affected breast and necessary surrounding tissue are removed, and a new breast mound is created using either your own tissue from another area of the body, a silicone or saline breast implant, or a combination of both. Immediate reconstruction has a number of advantages, including:
- You never have to go without a normal breast appearance
- Only one operation and recovery period are needed
- A surgeon skilled in nerve-sparing techniques may be able to preserve skin sensation in the breast
- Cosmetic results are usually better, as skin and breast shape are better preserved
- No difference in ability to detect cancer recurrences compared to delayed or no reconstruction
- No difference in rate of cancer recurrence compared to delayed or no reconstruction
Immediate reconstruction is typically a suitable option for women in earlier stages of breast cancer who do not need further radiation or chemotherapy treatments and is standard for patients who are at high risk of developing breast cancer and elect to have their natural breasts removed prophylactically. However, immediate reconstruction is not right for every patient, and you should take its possible disadvantages into consideration:
- Possible delays in receiving other treatments, such as chemotherapy
- More time spent in the hospital and a longer recovery than mastectomy alone
- Less time to think about your reconstruction options
Breast reconstruction performed after mastectomy surgery is considered delayed reconstruction. For patients who need to undergo radiation or chemotherapy treatments, delayed reconstruction is typically the recommended option. While having delayed reconstruction does mean that you will go through a period of time without a normal breast appearance, there are some advantages to this option:
- No delays in receiving other necessary treatments
- You have more time to think about your options
- Cancer treatment after mastectomy can be completed first, and therefore will not cause problems to the reconstruction site
A highly experienced breast reconstruction surgeon can achieve very beautiful, natural-looking results with delayed reconstruction. However, there are some potential disadvantages to consider:
- Overall more surgery and recovery time are needed compared to immediate reconstruction
- You will likely have a visible mastectomy scar on your chest wall
- Achieving optimal cosmetic results is more challenging
In some cases, breast reconstruction can be started at the time of mastectomy, and completed at a later date, by having a tissue expander or temporary implant placed. This allows a surgeon to preserve a patient’s breast skin and provide the appearance of whole breasts while a patient is undergoing chemotherapy or radiation, and also gives the patient additional time to think about her reconstruction options. When she is ready, breast reconstruction can be completed using a more permanent implant (although no implant will last a lifetime), or a natural tissue flap (via DIEP Flap or another procedure).
While for some patients, immediate-delayed reconstruction provides the “best of both worlds,” it does require more overall surgery and recovery time. Tissue expanders also can be uncomfortable for some patients, and while most patients do not experience major complications, there is an increased risk for infection from having a foreign object in the body.
Choosing the right option for you
At Breast Reconstruction Specialists, we understand that choosing when to have breast reconstruction is one of the most important decisions you will make during your breast cancer journey. Our surgeons have extensive experience performing DIEP Flap and other advanced procedures both as immediate and delayed reconstruction procedures and will help you choose the procedure plan that best fits your needs and goals.
Whether you are considering immediate reconstruction, or you have already undergone mastectomy and are ready to pursue breast reconstruction, you can trust our surgeons’ expertise to achieve a beautiful, natural-looking breast contour. Our priority is to restore your natural beauty and help you get back to your normal life as quickly as possible.