I am getting a double masectomy next week and I have a pacemaker. Can breast reconstruction be done with a pacemaker?

Best to ask your chosen surgeon in person concerning this very important issue in your reconstruction.....

I have helped reconstruct patient's who have pacemakers.  We had to discuss their individual case with their cardiologist to understand any potential limitations.  It also is important to know as much at your treatment after mastectomy.  Post mastectomy radiation will play a role potentially not how you plan the reconstruction.Three basic forms of breast
reconstruction exist. You can use your own tissue, implants or a combination of
the previous two techniques. Your own tissue can be used in the form of the
DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one
stage or two stage. Two stage reconstructions are started by placing expanders
at the time of mastectomy. Once they expanders are placed they are able to be
inflated as determined by wound healing. The final type consists of combining
any of the above techniques.

Yes, you can absolutely undergo immediate breast reconstruction if you have a pacemaker.   The surgeon will need to talk to your cardiologist to determine if you are pacemaker dependent or if the pacemaker is a back-up for rhythm disturbances.  Those answers will determine what will be necessary to do during your surgical procedure.The concern about the magnets in the expanders is not an issue.   These magnets are small and don't function in the same way as the larger magnets used to "program" your pacemaker (basically turn it on and off).  Best of luck on your upcoming procedures.