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Updated: June 2009

Immediate vs. Delayed Reconstruction

At times, concern for your health can overshadow the emotions that come with losing a breast. Living a long, cancer free life is the most important goal, but wanting to hold on to your femininity is just as essential to your well-being. If your surgeon recommends a mastectomy, in most cases you will have the option to choose whether to have immediate or delayed reconstruction. There is no absolute right or wrong choice, just which option best suits your needs.

Based on your risk factors and on information from your biopsy, your surgeon will have a general idea of the extent of your tumor. Unfortunately, the full extent of the cancer cannot be determined until the entire tumor is removed, and lymph nodes have been evaluated. In some patients, prior to any surgery, there may be signs of advanced disease, or it may be determined that radiation will be required as part of the treatment plan. If this is the case, it may be in your best interest to delay reconstruction until after all treatments have been completed.

There are advantages and disadvantages to both immediate and delayed breast reconstruction. While delaying reconstruction gives you time to focus on treatments, and research the type of reconstruction that best suits your needs, being without a breast can be emotionally devastating for some. Immediate breast reconstruction, which begins at the time of the mastectomy, has become the standard of care for most patients. The obvious benefit to immediate post-mastectomy reconstruction is the psychological and aesthetic advantage of waking up after the mastectomy with a lesser deformity and a reconstruction well underway. Also, immediate reconstruction can spare the patient additional stages of surgery and additional interruptions in her life. The primary drawback of immediate reconstruction is that it requires a longer surgery and recovery than just having mastectomies alone. Also, if radiation treatments are needed following surgery, the reconstruction may become compromised.

Regardless of whether an immediate or delayed approach is utilized, it is important to understand that it may take several procedures to achieve the final aesthetic result that is desired. The approach to reconstruction should be tailored to the individual needs of the patient.

Written and edited by our medical board