Immediate reconstruction following mastectomy is preferred since it preserves skin if necessary, reduces scarring, reduces time to completion and number of procedures, and obviated problems associated with delayed reconstruction.
However, your general surgeon, if he/she is doing the mastectomy, needs to coordinate both procedures with your plastic surgeon.
A prophylactic mastectomy is different than a "curative" mastectomy for cancer and may, in fact, be a partial, or subcutaneous mastectomy that might be performed by a plastic surgeon.
A plastic surgeon experienced with various types of situations and reconstructive options (autologous flaps, expanders, immediate or serial implants, various combinations) should be able to give you a clear picture of what you can expect once the dust settles.
