Breast Reconstruction: Q&A
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Breast Reconstruction Options
What are the benefits of having breast reconstruction at the same time as mastectomy, and in which situations would it be recommended to postpone reconstruction?
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29 Doctor Answers |
Asked by
Eva S
in Seattle, WA
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Immediate vs. Delayed Reconstruction
Immediate reconstruction generally facilitates a more elegant cosmetic result. But to determine if you are a candidate for immediate reconstruction will depend on your tumor biology, the need for radiation, and your overall health status. Delayed reconstruction is always an option (delaying your reconstruction until all your cancer care is complete). For patients who are not sure if they will need radiation, a newer modality is also available called the delayed-immediate...
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Immediate Reconstruction vs. Delayed Reconstruction
Most patients are candidates for immediate breast reconstruction. If you definitely need radiation treatment, you should consider delaying your breast reconstruction until after your treatment is complete.
For most other patients, immediate breast reconstruction have several advantages including:
1. Few surgeries and anesthetics
2. Improved Cosmetic Outcome
3. Smaller Scars
4. Psychologic Benefit / Impact
To learn more about the difference between...
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You and your surgeon will have to decide
Immediate breast reconstruction (at the time of mastectomy) has several advantages; it saves a surgery, the aesthetic results are better, there are psychologic advantages as well. Some complications, wound healing and infection rates are slightly higher with immediate reconstruction.
There are times when immediate reconstruction is not feasible and delayed would be better. Not everyone is a candidate for this. You and your surgeon will decide this.
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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...
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Breast reconstruction options
I think it is better to have reconstruction at the same time if possible. This is because you can compare what you have removed to what you are adding, and also can perform the reconstruciton with more supple tissue that is not scarred down. I would postpone it if the patient has a very large tumor, metastatic disease ( not just in the axillary nodes), and those that require radiation.
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Immediate versus Delayed Reconstruction
Immediate reconstruction after skin sparing mastectomy is by far the best way to get the most natural result possible. The only time I recommend waiting is if the patient requires postoperative radiation therapy and even then it is not a hard and fast rule. You will always get a better result with immediate reconstruction.
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Choosing breast reconstruction - details to consider
If you choose reconstruction, there are several details to consider. Reconstruction can be performed at the same time as your mastectomy (immediate reconstruction), or it can be performed at any time in the future following your mastectomy (delayed reconstruction). After any type of breast reconstruction, plans may be made to reconstruct a nipple and areola complex in the future. This may be performed at any time after a few months from your final reconstructive procedure. The breast...
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Immediate vs Delayed Breast Reconstruction
Immediate breast reconstruction makes the most sense for most as it eliminates the need for another surgical procedure and often results in a better final result. On the other hand, if the pathology of the specimen is in question and there is a potential for additional soft tissue removal then reconstruction should wait until this issue is resolved.
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Breast reconstruction options
Breast cancer is one of the most common forms of cancer in the United States today. About 1 in 8 women in the United States (12%) will develop invasive breast cancer over the course of her lifetime. There are many ways to treat breast cancer, and the conversation about your treatment may include discussion of chemotherapy before or after surgical treatment and radiation. When considering surgical treatment of the disease, however, the two options for...
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Breast reconstruction
In selected women, breast reconstruction may be performed at the time of mastectomy (known as immediate reconstruction). In some circumstances, breast reconstruction is performed on a delayed basis-this may be due to uncertainty of the cancer margins following mastectomy, or the need for post-mastectomy radiation therapy.
Chicago Plastic Surgeon
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When possible, it is generally better to have the breast reconstruction performed at the same time as the mastectomy.
The two key points here are that you need to discuss this with your oncologic surgeon, who is performing your mastectomy. If the feeling is that radiation may be necessary after the mastectomy, or that chemotherapy needs to be started immediately after the surgery, then you may want to consider postponing the reconstruction to a later date. If however, your oncologic surgeon feels you are a good candidate for immediate reconstruction, then there are many advantages to an...
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Immediate Breast Reconstruction Offers Advantages
Immediate breast reconstruction with flaps offers several advantages including:
the availability of an open mastectomy wound that allows for immediate breast reconstruction with an autologous tissue or flap reconstruction using your own tissues.
Breast reconstruction is in healthier tissues, before your mastectomy site is radiated
one hospitalization for the mastectomy and the primary breast reconstructive procedure with modestly longer recovery period
in...
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Timing for breast reconstruction
This is a very good questions. Breast reconstruction can be done at the time of mastectomy (immediate reconstruction) or can be done some time after the mastectomy is done (delayed reconstruction). Immediate breast reconstruction usually allows a better cosmetic result as the mastectomy skin is soft and not retracted down to the chest wall. Delayed reconstruction has a slightly fewer wound healing problems. The decision to get immediate breast reconstruction vs....
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Timing of Breast Reconstruction Surgery- Immediate vs. Delayed Reconstruction
Immediate reconstruction:
Immediate reconstruction with natural tissue allows a woman to wake up following a mastectomy with a reconstructed breast or breasts. For women who are candidates for skin-sparing mastectomy or nipple-sparing mastectomy, an immediate breast reconstruction generally offers the best possible aesthetic results. Immediate reconstruction preserves the greatest quantity of a woman’s own breast skin and also minimizes scarring on the breast. In addition,...
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Breast reconstruction at the time of mastectomy can have advantages
With the newer techniques available for breast reconstruction, more of my patients are eligible for immediate reconstruction.
My patient find that when they have immediate reconstruction, they wake up with a breast or at least a head start on breast reconstruction. Even my patients who choose tissue expanders can now wake up with a breast that is almost the same size as their previous breast with the newer techniques that are available. My patients tell me that this makes...
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Oxnard Plastic Surgeon
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Immediate vs Delayed Breast Reconstruction
This is a very good and highly debated question. Overall, I feel that immediate breast reconstruction is better from a cosmetic standpoint then delayed (in a majority of cases) and often times results in less procedures. All this depends on the quality of the mastectomy performed, the collaboration of the surgical oncologist and plastic surgeon, and the potential need for post-mastectomy radiation. Despite reports supporting the various sides, radiation will have a negative...
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Bakersfield Plastic Surgeon
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Breast reconstruction timing
In my practice, I favor an immediate reconstruction with a few exceptions. The benefits of immediate reconstruction are not only surgical, as one is typically operating in an unscarred field, but also psychological for the patient. Many studies have shown the positive impact of immediate reconstruction on patient's overall view of their breast reconstruction. In implant reconstruction, the immediate reconstruction takes advantage of the skin from the mastectomy to restore a significant...
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Timing of reconstruction
Well I have a different opinion about mastectomy and reconstruction. My reasoning is as follows. With immediate reconstruction you will wake up flat if we use an expander. Then the expander is enlarged over several weeks or months. During this time you doctors may decide that chemotherapy or radiation therapy is needed. I feel it is best to first cure the problem then start the reconstruction because radiation therapy may cause tissue changes requiring...
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When immediate breast reconstruction is the best option
Immediate breast reconstruction is preferable for two main reasons: #1 it does not allow the tissues to contract (tissues that contract are harder to work with later) and hence usually a better aesthetic result and #2 the patient has the psychological boost of knowing her reconstruction is mostly done (autologous tissue) or underway (implant reconstruction). There are several scenarios in which immediate reconstruction is not favored: extensive/advanced disease, anticipated post-op...
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Immediate reconstruction for early disease
Hello,
If you have early disease without the perceived need for chemotherapy or radiation, then immediate reconstruction is probably best. Skin sparing mastectomy leads to more tissue available for reconstruction and this is particularly important if an implant-based reconstruction is planned. If you have a lot of disease and the thinking is that radiation therapy or high dose chemo will be needed, then my tendency is to wait until the dust clears to plan the reconstruction.
This is...
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Timing of breast reconstruction depends on your particular situation
Breast reconstruction can be performed as an immediate or delayed procedure. When the circumstances permit, Immediate breast reconstruction has several advantages over delayed reconstruction. Among these are, one less surgical procedure requiring anesthesia, the tissue is supple allowing for a potentially better cosmetic outcome, psychologically the patient goes to sleep with a breast and wakes up with one (or the beginning of one), there is one recovery for two procedures (mastectomy and...
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Breast reconstruction timing depends on your specific situation
Teresa,
There is not one answer for this question. It really depends on your specific situation and would be best be answered by your breast surgeon. Factors which effect the answer include your stage of cancer, need for radiation or other treatment, skin envelope, etc. Good luck with your surgery.
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Indications for timing of breast reconstruction vary on a case to case basis.
Ultimately, the decision whether to undergo immediate or delayed breast recosntruction depends on patient preference. Certain factors, such as advanced tumor stage and the need for radiation therapy, tend to favor delayed reconstruction to optimize oncologic and aesthetic outcomes.
There is sufficient data to support the fact that a woman's breast cancer prognosis is not negatively affected by the timing of breast reconstruction.
There are of course advantages and disadvantages to both...
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Immediate is good, but delayed may be better for you
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,...
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Better to have it done at the same time
It is better to have reconstruction at the same time. If you will need radiation therapy you may get a better result if you delay reconstruction especially for the autologus breast recconstruction.
The main reason for the combine procedure is to prevent scaring that willl happen with the 2 stage reconstruction.
You need to discuss this with your plastic surgeon and see what he is comfortable with.
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Generally, plastic surgeons and patients prefer to do the reconstruction at the same time
The benefits of having the recontruction at the same time are a better cosmetic result (the majority of the time) and an overall happier patient. Multiple studies have shown that patients who have the reconstruction done at the same time experience less depression and have greater satisfaction, as they always have a breast.
In addition, a skin sparing mastectomy can be performed if the reconstruction is done at the same time, which means a shorter scar for you. This being said, in some...
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Many factors to take into consideration
In instances where the outcome of your biopsy or lumpectomy or mastectomy procedure may alter the course of your post-operative adjuvant (chemotherapy or radiation therapy) it may be wise to delay.
In instances in which the survival of the skin flaps may be questionable (diabetes, smoking, multiple precvious surgeries), you may want to delay.
In cases of high risk of contralateral breast carcinoma, you may want to delay.
Otherwise, the vast majority of women choose to have mastectomy and...
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Immediate is better if no radiation
Immediate breast reconstruction with either implants or your own tissues has several advantages:
1-The skin available after mastectomy is used immediately for reconstruction. Other wise you could loose some of the elasticity and stretch in delayed cases.
2-The psychological effect of a mastectomy is much less since there will be a breast either with expanders or your own tissues. The subsequent stages will shape it more and add the nipple reconstruction.
3-You are already under anesthesia...
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An excellent and complex question
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...
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