What is the best timing for breast reconstruction surgery?
By: Dr. Minas Chrysopoulo
In terms of the psycho-social benefits and cosmetic results, breast reconstruction at the same time as the mastectomy is preferred whenever possible.
"Immediate reconstruction" is the term used when reconstruction is performed at the same time as the mastectomy. "Delayed reconstruction" usually takes place several months after the mastectomy but there is no set time limit. Reconstruction can be performed literally years after the mastectomy.
Immediate reconstruction enables the patient to wake up from the surgery "complete" and avoid the experience of a flat chest completely. Most women with early breast cancer (stage I or II) are candidates. Immediate breast reconstruction is generally associated with more natural results, and less scarring.
Whether the reconstructive process is started at the time of the mastectomy ("immediate") or some time after ("delayed'), it important for patients to realize that in most cases, further surgery is required to complete the reconstructive process. For many women, the reconstructive process can therefore take many months to complete.
In cases where radiation is anticipated following the mastectomy, many surgeons advocate delaying reconstructive surgery until all breast cancer treatment has been completed to decrease the risk of complications. This is because radiation can sometimes damage the reconstruction. Much also depends on the radiation oncologist's experience in treating breast reconstruction patients. Other reasons for delaying reconstruction include advanced disease (stage III or IV), lack of access to a reconstructive surgeon, or patient preference.