Mastectomy and Breast Reconstruction - Can the Procedures Be Combined?

My mom gets really painful cysts in her breasts constantly. It's not cancer, but she is tired of having tons of biopsies and plans to have a mastectomy later this year. From what I recall when my grandmother (my dad's mom) had a mastectomy due to breast cancer, she had to wait some time before having the breast reconstruction. But I was wondering if there is any way the two procedures could be done in succession, during the same surgery session, in cases like this where there is no breast cancer involved.

Doctor Answers 33

Immediate Breast Reconstruction at the time of Mastectomy.

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Breast reconstruction has come a long. Years ago it was believed that the patient had to see how it was not to have a breast to appreciate what ever results she had with breast reconstruction.

With the advent of live tissue reconstruction in 1982, the use of breast expanders around the same time and recently the use of allograft dermal matrix, the reconstructions are very successful. Ninety % of the reconstruction that I perform today are immediate, combined with the mastectomy.

Breast reconstruction can be done immediately or delayed

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Breast reconstruction can be performed at the same time as a mastectomy, or after a period of "delay". In the "old days", the thought was that a woman should live for a period of time without her breast so she would be more likely to be happy with the reconstruction. This is, of course, appalling' and no longer the case.

Contemporary plastic surgeons such as myself and others answering this question will tell you that the best aesthetic result will be with an immediate breast reconstruction at the same time as mastectomy. This can be performed in many ways, and the procedure selected should be tailored to the patient's body, medical history, and lifestyle. For a great resource, check out the American Society of Plastic Surgeons website which has excellent educational information for patients and family members.

The two procedures can be done at the same time. In a...

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The two procedures can be done at the same time.

In a cancer operation not only is the breast tissue removed but the skin is removed as well. In that situation, the reconstructive surgeon may elect to place a tissue expander to stretch the skin over time and return at a later date to place the permanent breast implant.

Since this is not a cancer operation no skin will need to be taken, allowing the surgeon to place the permanent implant at the time of the mastectomy. In fact, the nipple and areola can also be maintained, which will help the final cosmetic result.

This is not uncommon and your general and plastic surgeon will be able to help you and your Mom understand the options available to her. She should do well with this procedure.

I wish you all the best.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

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Immediate Breast Reconstruction - combining mastectomy and reconstruction

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I'm sorry to hear of your mother's problems.

Breast reconstruction can be performed at the same time as a mastectomy - in fact, for the patient who doesn't need radiotherapy, like your mum, this is the ideal time to perform a breast reconstruction. The breast surgeon will be able to leave all of the breast skin behind and then the plastic surgeon can recreate the breat mound using either an implant (the simplest way), or a flap (usually from either the back or the abdomen), or sometimes a combination of the two.

I wish you and your mum good luck.

Immediate Reconstruction following Mastectomy - Best Choice for Most

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Actually immediate reconstruction following mastectomy yields the best results in general and is the preferred technique.

Breast reconstruction at the time of mastectomy

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Breastv reconstruction is commonly done at the time of the mastectomy.

Today surgeons are performing skin sparing and even nipple sparing mastectomies .There is therefore  much less need to bring in extra skin by means of a flap

Implants or adjustable implants can be placed either under or above the muscle

Often re inforcement is needed, in these,cases we use absorbable mesh or acellular dermal grafts

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Breast Reconstruction at the time of mastectomy

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Breast reconstruction at the ime of mastectomy is commonly done as:

  • it afford the patient the advantage of having one anesthesia and one hospital stay
  • takes advantage of the mastectomy wounds which allows access to the blood vessel in the chest needed to provide blood supply to the skin and fat (DIEP) free flap
  • some patients preferred not experience a mastectomy deformity

Sometimes breast reconstruction is best done at a separate time from the mastectomy:

  • If the patient is unsure of whether to do a breast reconstruction
  • If the patient is unsure of which breast reconstruction technique she may want.

Fredrick A. Valauri, MD
New York Plastic Surgeon

Immediate Breast Reconstruction

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Breast reconstruction after mastectomy can be performed at the same time as the mastectomy (immediate) or some other time after the mastectomy (delayed).

There are many breast reconstruction techniques and a consultation with a board certified plastic surgeon is necessary to determine the best options.

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 82 reviews

Combining Mastectomy and Breast Reconstruction

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As you indicated in your question, many women undergo a mastectomy for reasons other than breast cancer. Chronic pain from cysts such as you describe may be one indication. BRCA positive patients, who are at elevated risk of developing breast cancer, also may choose to have a mastectomy. Many years ago, breast surgeons did not recommend immediate reconstruction. However, today we routinely perform immediate reconstruction. For patients without breast cancer, almost any type of breast reconstruction may be done immediately.

James N. Romanelli, MD, FACS
Long Island Plastic Surgeon
4.4 out of 5 stars 25 reviews

Combined mastectomy and breast reconstruction is possible

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The combined procedure is possible, and often times, the preferred method of breast reconstruction.   This "immediate" reconstruction allows for the best aesthetic result because the skin of the breast is saved and an implant or "self tissue" (DIEP, TRAM, etc) can be placed inside the original breast pocket.   The general surgeon and plastic surgeon work together with the first surgeon removing the breast tissue and the second surgeon reconstructing the breast in a single stage.  This is the key advantage.  The disadvantage can be wound issues from thin mastectomy flaps and/or unresolved oncologic issues at the time of reconstruction. 

Charles K. Lee, MD, FACS
San Francisco Plastic Surgeon
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.