Once a woman has decided that she wants to have a breast reconstruction the next step is to decide on the best time to have the procedure.
Breast reconstruction performed at the same time as a mastectomy is called “immediate breast reconstruction” and reconstruction performed sometime after mastectomy is called “delayed breast reconstruction”. On occasion, a delayed breast reconstruction is performed within just a few weeks of mastectomy surgery, and is sometimes referred to as “immediate-delayed breast reconstruction.”
Each approach has specific advantages and disadvantages, and we will work with you to determine the optimal approach for your specific situation.
Immediate reconstruction allows a woman to wake up following a mastectomy with a reconstructed breast. For women who are candidates for skin-sparing mastectomy or nipple-sparing mastectomy, an immediate breast reconstruction generally offers the best possible aesthetic results. Immediate reconstruction preserves the greatest quantity of a woman’s own breast skin, minimizes scarring on the breast, and helps produce the best and most natural-looking results. In addition, immediate reconstruction will reduce the number of surgical procedures needed to treat a woman’s breast and reconstruct it, and reduce the total amount of time required for recovery and recuperation.
Although recent studies have shown that breast reconstruction surgery generally does not delay further cancer treatment (including chemotherapy and hormone therapy), your breast cancer surgeon or oncologist may recommend that reconstruction not be performed at the time of mastectomy.
If your postoperative treatment plan includes radiation therapy, we will generally recommend that natural tissue reconstruction be delayed until several months after radiation therapy is completed, however, we can often place an implant at the time of mastectomy to help preserve a maximal amount of a woman’s own breast skin and optimize the final aesthetic results.
Some women choose to delay breast reconstruction until sometime after mastectomy. Sometimes delaying reconstruction is done at the recommendation of the breast surgeon or oncologist. Other times women may wish to get out of the hospital as quickly as possible after mastectomy and opt to undergo a reconstruction at a more convenient time. Still others initially decide not to have reconstruction, but later decide they want to have a breast restored. And some women, not fully informed about their options for breast reconstruction prior to mastectomy, sadly, learn about reconstructive options only later.
In most cases, successful breast reconstruction can take place even after a delay of many years.
Delayed reconstruction can also be done for someone who is unhappy with a previous reconstruction. Women who are not satisfied with a previous natural tissue or implant reconstruction may elect to undergo a reconstruction well after the original procedure. Women who are dissatisfied with an implant reconstruction, for example, may decide to have their implants replaced or removed and replaced with their body’s own tissue.
Because the best and most reliable results of perforator flap breast reconstruction are typically obtained by surgeons who perform a high volume of this particular type of surgery, some women may choose to have a mastectomy with a breast surgeon in their local community and subsequently undergo reconstruction with a plastic surgeon who specifically specializes, as we do, in breast reconstruction surgery. Immediate-delayed breast reconstruction has a role in these and other situations. Of course, for women who live out of town and prefer to have an immediate breast reconstruction procedure, our staff can help plan an itinerary for consultation and, on the same visit, mastectomy and immediate reconstruction surgery in New York or Connecticut.