Immediate vs. delayed reconstruction

Your surgeon and others on your care team will help you decide whether to have immediate or delayed breast reconstruction. Your choice may depend on your cancer treatment plan and personal preferences.

Immediate reconstruction

Immediate reconstruction happens at the same time as mastectomy. Both your breast surgeon and plastic surgeon will operate during the same surgery. Once your breast is removed, it will be reconstructed with tissue from another part of your body, an artificial implant, or both.

You may be able to have immediate reconstruction if your upcoming cancer treatments will not affect the surgery, and if you feel mentally prepared.

Pros of immediate reconstruction may include:

• One fewer surgery
• Possibly better-looking results due to preserving more breast skin
• Being able to recover from mastectomy knowing that you started the breast reconstruction process

Cons of immediate reconstruction may include:

• Longer total surgery time to remove the cancer and rebuild the breast
• Higher risk of complications than delayed reconstruction
• One more thing to handle during cancer treatment

About one-third of women who have a mastectomy have immediate reconstruction. Immediate reconstruction is not right for all women, and many don’t feel comfortable deciding right away.

Delayed reconstruction

Delayed reconstruction can start months or even years after your first breast cancer surgery. You may want to consider it if you:

• Are having radiation therapy to the chest after surgery. Radiation may damage reconstructed tissue by causing it to shrink; change color, feel, and look; delay healing; or cause scarring around an implant.
• Need chemotherapy. Your oncologist may prefer you focus on your cancer treatments first.
• Want more time to think about your options.
• Prefer to make one decision at a time and recover from one surgery before having another.
• Have had reconstruction before.
• Have risk factors for complications.
• Have other things going on in your life (for example, you have young children or an elderly parent to care for, a busy job, or other health concerns).

Your recovery from the first stage of your reconstruction depends on which procedure you choose. Ask your surgeon to explain which you can have and the pros and cons of each. Follow-up procedures may include revision surgeries on the reconstructed breast or the opposite breast, as well as nipple-areola reconstruction.

A number of factors can affect whether you have immediate or delayed reconstruction, including the stage of cancer, the expertise of surgeons in your area, how you make decisions, and your overall health. Take time to make the best decision for you.