Finding the right time for your breast reconstruction can be a complex decision. It involves weighing factors that are unique to your situation and having collaborative conversations with your medical team. In the end, you’ll come together to choose one of three strategies: immediate breast reconstruction, delayed breast reconstruction, or hybrid immediate-delayed breast reconstruction, also known as a “staged” approach.
At The Breast Center Park Meadows Cosmetic Surgery, our board-certified plastic and reconstructive surgeons consider it a privilege to guide you through your options. While the final decision regarding when to start your breast reconstruction may not be made at your consultation, this initial meeting is a great place to start.
When Should I Have My Breast Reconstruction?
Some women begin reconstruction on the same day as their mastectomy, while others wait due to personal preferences or the specifics of their cancer treatment. The right timing for you will depend on a host of different factors, including:
- Your current health
- The details of your cancer
- Your decision to pursue a prophylactic mastectomy or lumpectomy, if applicable
- Your plans for chemotherapy or radiation therapy
- Your goals and preferences
- Your readiness to think about reconstruction
- Feedback from your breast oncologic surgeon
- Feedback from your radiation oncologist
Our surgeons will spend time explaining the benefits and considerations associated with your different timing options. They will make sure to relate everything to your unique situation, including the surgical steps, recovery, and results you may be able to expect. By giving you a complete picture of your options, our surgeons hope to make it easier for you to choose what’s best for you.
Immediate Breast Reconstruction
Immediate breast reconstruction is when the primary breast reconstruction surgery is completed the same day as your mastectomy. It is also known as a one-stage reconstruction. Newly diagnosed breast cancer patients may be candidates for this approach.
This type of breast reconstruction can be performed with either implants or using an autologous tissue approach. If implants are used, the procedure is referred to as direct-to-implant reconstruction.
After the general surgeon completes the mastectomy, our plastic surgeons step in to either place an implant in the breast pocket or take the skin and fat from the donor site and create the new breasts.
The advantages of immediate breast reconstruction include:
- Preserving more native skin from the breast
- Providing a slightly better cosmetic result in many cases
- Working in a breast that has minimal or no scar tissue
- Waking up with a breast mound
- Convenience of combining the mastectomy and the primary stage of the reconstruction
- Avoiding the use of tissue expanders
Some disadvantages of immediate breast reconstruction include:
- The reconstruction could be adversely affected by postoperative chemotherapy and radiation therapy
- It may be too much information for you to absorb in a short time, and you may feel overwhelmed by your options
- It may present some difficulties for women with larger breasts
- It may not be the right option for locally advanced breast cancers
Delayed Breast Reconstruction
The term delayed reconstruction refers to breast reconstruction that is performed when a patient has already had their mastectomy at an earlier date. The mastectomy could have been carried out months, years, or decades prior to reconstruction.
There are almost always techniques that can be considered for patients pursuing delayed reconstruction. In some cases, tissue expanders and implants can be used. Frequently, however, you may need to consider using an autologous tissue reconstruction in which skin, fat, and sometimes muscle is moved from a distant site to the chest to build the breast.
Benefits of a delayed reconstruction strategy include:
- The timing of surgery can be optimized for your health status
- Chemotherapy and radiation therapy is already done
- Likely a lower infection rate than immediate breast reconstruction
- You can consider your options carefully, and there is no rush to decide on a technique
Disadvantages of delayed breast reconstruction include:
- There is usually less native breast skin preserved to make a breast
- Often harder to get a superior cosmetic result
- You require at least one extra operation since the reconstruction was not combined with the mastectomy
Staged Breast Reconstruction
Immediate-delayed breast reconstruction refers to a reconstruction that begins on the same day as the mastectomy. A tissue expander (or “place saver”) is placed into the mastectomy defect immediately after the general surgeon removes the breast.
Following tissue expander placement, the chest area is allowed to heal. You can go on to receive chemotherapy and radiation if those therapies are part of your treatment plan. After a period of recovery, you will undergo another surgery in which the tissue expander is removed and replaced with a tissue flap or breast implants.
The staged approach combines many of the advantages and considerations associated with the other two surgical timing options. For example, the tissue expander temporarily gives you a breast mound while you are progressing with their other therapies or deciding on which type of reconstruction to undergo. However, the approach requires one more surgery than immediate reconstruction does.
Planning for Breast Refinement Procedures
Our surgeons often perform minor procedures several months after primary breast reconstructions to achieve the most aesthetic outcomes. Your options for breast refinement after reconstruction may include shaping and fat grafting, nipple reconstruction, and areola pigmentation.
These options can vary based on your unique situation. For instance, if you had a nipple-sparing mastectomy, you won’t need nipple reconstruction.
Which Type of Breast Reconstruction Is Right for Me?
There are several different types of breast reconstruction. The leading techniques include autologous or flap-based procedures, implant-based surgeries, and the hybrid approach (a combination of both of these two strategies). Our breast reconstruction surgeons will take the time to discuss your options and empower you with the information you need to make this important decision. Your ideal procedure will depend on factors such as your cosmetic goals, your lifestyle, and the details of your cancer treatment.
What Are the Benefits and Risks of Staged Breast Reconstruction?
Staged breast reconstruction, also known as immediate-delayed breast reconstruction, is a timing option that comes with a specific set of benefits and risks that you will need to consider. Our surgeons are committed to helping you understand all of the choices available to you. For example, staged breast reconstruction allows you to start your reconstruction journey while finishing certain types of cancer treatments such as chemotherapy and radiation. It can begin to give your breasts shape during a time when so many other factors may seem out of your control. It also gives you time to decide which type of reconstruction you want to pursue. However, staged breast reconstruction requires at least one more procedure than immediate reconstruction. It also involves appointments to fill the tissue expanders. Some women want to shorten their reconstruction timeline as much as possible and prioritize this goal above other factors. You will need to weigh your own goals and preferences with the help of our surgeons.
What Are the Benefits and Risks of Breast Revision Procedures?
Breast revision procedures are typically performed after primary reconstructions to provide better cosmetic outcomes. Options such as nipple reconstruction, fat grafting, and areola pigmentation can significantly increase your satisfaction with your breast reconstruction results. These surgeries and techniques are often less involved than the initial procedures. They tend to come with lower complication rates and fewer risks. Of course, all benefits and considerations will be discussed ahead of time so that you can make an informed decision about refinement.
How Soon After Mastectomy Should You Get Breast Reconstruction?
Your breast reconstruction timing is a very personal thing. It is also something that will be affected by factors such as the details of your cancer and your breast cancer treatment. Depending on what makes sense for your situation, it may be possible to begin or complete reconstruction on the same day of your mastectomy. It can also be performed at a later time.
How Soon After Each Type of Breast Reconstruction Will I See Results?
Flap-based breast reconstruction and implant-based breast reconstruction provide immediate results. You will have a new breast mound following either of these surgical approaches. However, your results will likely be obscured by dressings, swelling, and bruising at first. As you progress through the healing process, your results will continue to look better and more natural.
Learn More About Breast Reconstruction Timing in Lone Tree
For many women, reconstruction is an important part of reclaiming a sense of wholeness and achieving a more positive self-image. You can rest assured that during every step of the process, our experienced staff here at The Breast Center Park Meadows Cosmetic Surgery will be ready to meet your needs and address any concerns you have.
Schedule a consultation at 303-706-1100 to begin making a plan for your breast reconstruction timing. We proudly serve patients from Denver and Lone Tree, Colorado, as well as across the country.