When should I start the process of breast reconstruction?

You can start the process at the same time your breast is removed, or you can wait until later.

Immediate breast construction: Reconstruction at the same time as when your breast is removed.
Delayed breast reconstruction: Reconstruction months or years after your breast is removed.

Immediate breast reconstruction

When you start the process at the same time that your breast is removed, more of the breast skin is saved. This can help make the look and feel of your reconstructed breast more natural.

If you need a tissue expander, it will usually only be partially filled, so you will not have a full breast shape at first, but you do not have to live without the shape of a breast for very long. Several steps are often needed to get the final shape.

If you are thinking about immediate reconstruction, ask:

What needs to be done after the first step?
How long it might take to reach the final shape of your breast?

Doctor consulting senior patient, reviewing notes

Delayed breast reconstruction

Delayed reconstruction may be a better choice for you if:

You don’t want to think about reconstruction while going through cancer treatment
You smoke or have serious health problems
You might need radiation treatment after surgery

Radiation treatment and reconstruction

If you need radiation after mastectomy surgery, it could affect how you heal and your chance of having side effects from reconstructive surgery, such as:

Slower healing
Different scarring
Changing how your reconstructed breast looks and feels, such as making it harder and stiffer

If you need radiation, surgeons might recommend you have delayed reconstruction with a flap rather than an implant. A flap is when surgeons move tissue with its blood supply from one part of the body to another.

Comparing immediate and delayed reconstruction

	Immediate	Delayed
Side effects from reconstruction surgery (major infection, the incision re-opening, or tissue damage)	The chance of side effects is higher compared to delayed reconstruction.	The chance of side effects is lower compared to immediate reconstruction.
Scarring	The scar on your breast is usually smaller.	The scar on your breast is usually longer.
Number of surgeries or steps	You will have at least 1 less surgery compared to delayed reconstruction.	You will have at least 1 more surgery, compared to immediate reconstruction.
How long you will live without a breast shape	You will not have to live without a breast shape for very long.	You will have to live without a breast shape for a period of time, but you can wear a breast form during that time.
Healing and recovery	You will have limited time to recover between surgery and any other cancer treatments (such as Chemotherapyerapy)that you may need.	You will have completed most or all cancer treatments (such as Chemotherapyerapy) before starting reconstruction.
Time to prepare yourself	You will need to make decisions about reconstruction and prepare for the reconstructive surgery at the same as you are going through cancer treatment.	You can take more time to think about if you want reconstruction and focus on your cancer treatment. You can also take time to get ready for the surgery. For example, if you smoke, you can try to quit. If you are overweight, you can try to lose weight.

Click here to read about peoples’ experiences with immediate and delayed reconstruction

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