Robert J. Allen M.D.

Immediate Versus Delayed Reconstruction

A common misconception is that breast reconstruction always takes place as its own procedure, separate from and following the mastectomy operation.  And, while traditionally this may have been true, nowadays, this is often not necessary.  In fact, breast reconstruction can take place at various stages of the breast cancer process.  While breasts may still be reconstructed well after a mastectomy has been performed, what is termed a delayed reconstruction, the reconstruction can also take place simultaneously with the mastectomy, called an immediate reconstruction.  And, immediate reconstruction has many advantages.

Aesthetically, immediate reconstruction offers a better cosmetic result as it allows for a skin sparing mastectomy, which preserves the original breast skin envelope for volume and shape to be immediately restored.  Incisions and scarring can be minimal and excess skin can be built right into the nipple reconstruction.  Additionally, for some patients, the nipple can be preserved with a skin sparing mastectomy, reducing a multi-stage reconstruction to just one stage, and in other words, just one procedure. From a surgical perspective, immediate reconstruction means less surgery by condensing two operations into one.  And lastly, immediate reconstruction makes a very traumatic, disturbing experience a little less traumatic and disturbing.  Patients go to sleep with breasts and wake up with breasts – no need to walk around feeling disfigured, embarrassed or a loss of one’s womanhood.

Depending on the course of cancer treatment, not all patients are candidates for an immediate reconstruction.  This can be discussed and determined by your breast surgeon.

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