Teresa: I can only give you some general answers and suggest you speak with your breast surgeon (surgical oncologist), plastic & reconstructive surgeon, medical and possibly radiation oncologists. I am sorry that you are facing these challenges and wish you the best.
There are many factors that go into the decision about immediate or delayed breast reconstruction. Your preferences, physical health & risk factors, and emotional state are important considerations. Your tumor size, location, lymph node involvement, and tumor markers may determine some choices. The method of reconstruction you choose is important (autologous tissue, flap or expander/implant). The type of mastectomy your surgeon plans is important. Whether you need radiation therapy and when is important.
When all factors are most favorable, I suggest immediate reconstruction after skin-sparing mastectomy. I am happy to vary my technique and recommendations to the needs of patients and often use other approaches. The main benefits are quicker reconstruction, less scaring and distortion, and the ability to coordinate with the removal surgeon. The most common reasons to postpone are possible radiation therapy and patient health reasons.
