Many variables to answer that question

Immediate breast reconstruction is an option for the majority of women getting a mastectomy. Keep in mind though, that breast reconstruction (even when considered immediate), often requires multiple steps to get it as symmetrical and aesthetically pleasing as possible. Delayed reconstruction is an option, but the skin envelope often contracts, which may require bringing in tissue in the form of an abdominal or latissimus flap. Good Luck!

Your unique situation would clearly require a consultation. 

Breast reconstruction involves a variety of techniques and methods which are too detailed to discuss in this format. Important information to acquire during a consultation involves a long history to document:

• family history,
• future risk,
• methods/approaches/incisions for cancer removal (biopsy, lumpectomy, partial/total mastectomy),
• management of the opposite breast (enlargement, reduction, or lift), previous surgical procedures,
• adjuvant treatment protocols (radiation or chemotherapy), etc.

There are many issues to discuss:

• Will your reconstruction be done at the same time as the mastectomy or at a later date? 
• Are you in good enough health to undergo a combined procedure?
• Do you smoke?
• Do you want your own tissue (stomach/back/buttock) or an implant or a combination of both?
• Can your body provide sufficient tissue for reconstruction?
• In regards to the opposite breast, you may want to reduce the large breast or enlarge the small breast. A breast lift may also be in order. Reduction and or lifts can be completed using a variety of techniques depending on the amount to be corrected and the degree of asymmetry. Areolae can be made smaller.

As you can see, this is not an issue which can be discussed over the internet. Depending on the results of this discussion with your surgeons, the answer may become clear.

In the past, delay was recommended to ensure adequacy of cancer removal as well as assessment of the quality of the remaining skin.

However, the vast majority of patients seek immediate reconstruction for its psychological beneifts which should not be discounted. Several studies have dispelled earlier concerns about delaying diagnosis of recurrence and have shown that immediate reconstruction does not effect cancer survival.

I hope this helps!

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