Dear Motleyminerva,Thank you for your question. Immediate breast reconstruction is where reconstruction of the breasts takes place at the time of mastectomy. It may be performed in a staged fashion (more than one surgery) versus being performed in a single stage. A staged approach may consist of placing a breast spacer or tissue expander, which is a temporary prosthesis placed in the breast envelope at the time of a mastectomy. This may help to preserve precious native skin to be used for future reconstruction and may help to buy time while still gathering information regarding possible cancer treatment needs, such as chemotherapy and/or radiation, if at all needed. In order to allow the skin incisions to heal, the expander may not initially be inflated or may only be partially inflated, so as not to place tension on the skin incisions. The expander may be inflated or deflated over time during an office visit, as needed, and eventually removed in a separate surgery, and replaced with a permanent implant or potentially, your own tissue. In contrast, a direct-to-implant breast reconstruction, is where a permanent breast implant is placed at the time of the mastectomy. Each approach may hold its own set of risks and benefits, and these may vary from patient to patient. It is important to evaluate each individual patient to determine specific needs and best treatment options. I suggest that at this current time, you seek a virtual consultation with a board-certified plastic surgeon to be evaluated and to determine your options. Best wishes and stay safe!
