Ask the Expert

Timing for Breast Reconstruction

Question: If I choose to have breast reconstruction, how soon after my mastectomy will the surgery be performed?

Answer: Reconstruction can begin immediately following mastectomy (immediate reconstruction) or it can be performed after recovering from the mastectomy (delayed reconstruction). A variety of factors are considered when determining the timing of the reconstruction.

With immediate reconstruction, you will be able to start your reconstruction at the time of the mastectomy. You will be saving yourself another surgery, which may be beneficial emotionally. The remaining skin envelope after mastectomy is also more pliable at this time. The surgery itself will be longer as two separate procedures are performed in the same operating room and recovery may be more difficult. However, patients generally prefer immediate reconstruction and in most cases, the risk level is considered acceptable.

With delayed reconstruction, you have the benefit of eliminating the cancer and concentrating on the treatments that may follow, like chemotherapy and radiation, prior to reconstruction. In immediate reconstruction, treatments can be pushed back if there are any post-surgical complications, but delayed reconstruction focuses on treatment first and reconstruction later.

For patients with certain health risks or lifestyle choices, delayed reconstruction may be recommended by the plastic surgeon. These patients would include active smokers, morbidly obese patients, diabetic patients, or those who would benefit from shorter surgeries due to their medical histories. Smokers, obese patients and diabetics all have higher risks of infection and wound healing issues following surgery, so separating the mastectomy and reconstruction may aid in recovery.

Because every patient is different, your treatment and surgery plans should be carefully reviewed with your cancer care team to determine the timelines that will provide the best outcomes.

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