When Should You Schedule Your Reconstruction?


There’s no question that breast reconstruction can be an important part of the physical and emotional healing process for any women faced with breast cancer, and today women have more options than ever when it comes to reconstructive breast surgery. One of these choices includes making the decision between immediate vs. delayed reconstruction. What’s the best time to schedule your breast reconstruction?
Delayed Reconstruction1.Delayed breast reconstruction after breast cancer means that your surgeon waits until you’re fully healed from your mastectomy and have also completed any additional treatments (such as chemotherapy or radiation) before beginning the process of reconstruction. Although more surgeons are turning toward immediate reconstruction these days, this doesn’t mean that there aren’t still some advantages to choosing a delayed approach:
Simplifies the immediate decision-making process for patients who are newly diagnosed with breast cancer and likely overwhelmed by information overload already.
Offers women more time to research breast reconstruction methods as well as find the best reconstructive surgeon for your preferred approach, who may not be as easily scheduled on short notice.
Grants a less rushed, more generous grieving period for the loss of your natural breast before moving on to the next stage of your recovery.
Perhaps most importantly, choosing delayed reconstruction ensures that the primary issue—your health—takes priority over the aesthetic question of reconstruction, allowing both patient and doctor to fully focus on the respective task at hand.
Immediate ReconstructionThe phrase “immediate breast reconstruction” may be used in one of two ways:
A true immediate reconstruction, where the breast implant or tissue flap is used to recreate the breast mound during the same surgery appointment as the mastectomy.
The first of many stages of reconstruction is performed at the time of the mastectomy, typically placing a temporary implant known as an expander that will later be replaced with a breast implant.
The benefits of immediate reconstruction include limiting the number of surgeries and recoveries a patient may have to undergo during what is already a stressful time.
Immediate breast reconstruction also complements the modern-day philosophy toward breast cancer treatment, which increasingly focuses on preserving as much natural tissue as possible. This may be through performing a nipple-sparing and/or tissue-sparing mastectomy, or shrinking the tumor as much as possible with chemo or radiation to allow for a lumpectomy to be performed rather than a full removal of the breast.
This conservative, tissue-preserving mindset has led to an increasing interest in lumpectomies. When a lumpectomy requires reconstruction and the two procedures are combined at the same time (known as oncoplastic surgery), the final contours of the breast are often superior compared to a delayed lumpectomy reconstruction.
The Perfect TimingPlanning the  right timing for your breast reconstruction depends on a number of factors, not the least of which is your overall health. Different considerations must be weighed in deciding whether immediate or delayed reconstruction is the best option for you: if a lumpectomy or mastectomy is being performed, if your preference is for implant-based or tissue flap reconstruction (or you’re a candidate for one over the other) and whether radiation treatment or chemo will be necessary after your initial breast surgery.
It’s important to discuss your goals with your oncologist as well as your plastic surgeon in order to ensure proper coordination between your cancer treatment and your reconstruction surgery for the best possible outcome.
Article by
Orange County Plastic Surgeon