Either approach can work well

Teresa,

This is a great question, and I imagine you will see lots of different answers to it.  Some plastic surgeons will only perform a delayed reconstruction (postponed until after all of your breast cancer treatments are complete) while others offer immediate reconstruction to their patients. 

In my practice, I will offer an immediate procedure to women who desire an immediate reconstruction, who are in overall good health and don't smoke, and who do not have advanced disease which would likely require radiation therapy.  I think the advanatges to an immediate reconstruction in this case are one less surgery for the patient, less time between mastectomy and final reconstruction, and less time, if any, without a breast mound.  There are some disadvantages, however, including the risk of delayed wound healing, infection, and if radiation is required, possibly a less than ideal cosmetic result or even complete loss of the reconstruction.

This is something that you need to sit down and carefully discuss with your surgeon in detail so that the two of you can put a plan together that works well for you.  Remember, the first goal is to get you cancer-free-- everything else takes a back seat.

Best of luck,

Dr. S

The issue of immediate versus delayed reconstruction is very complex and has different answers for each patient. In general, the benefits of immediate reconstruction are to minimize the number of surgeries required and to soften the psychological trauma of the mastectomy. If a patient is a candidate for a "skin sparing mastectomy," an immediate reconstruction is advantageous.

On the other hand, there are often benefits from delaying the reconstruction. Breast cancer treatment is a complex matter and it is generally advisable to sort out all of the cancer treatment issues before initiating reconstruction. It always creates a problem when an immediate reconstruction is done and then the pathology report returns indicating that further treatments such as radiation are needed that weren't anticipated before the mastectomy.

The best advice I can give you is to visit with 2 or 3 Board Certified Plastic Surgeons who have a special interest in breast reconstruction and can offer you all of the possible methods including microsurgical tissue transfers and sort out what would be the best plan for your particular situation.

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