When Can Breast Reconstruction be Performed?

Each breast cancer is unique, and each reconstruction surgery and its timing are unique. Breast reconstruction can be done at different times, depending on what works best for your situation. Your breast reconstruction team in Dallas, TX will work closely with your other doctors to determine the best possible treatment for you as well as optimal results for reconstruction.  

At the same time as mastectomy surgery

This is called immediate reconstruction. As soon as the breast is removed by the breast cancer surgeon, the plastic surgeon reconstructs the breast either with tissue from another location on your body or with an implant (and sometimes both). Nearly all of the work is done during one operation, and you wake up with a rebuilt breast (or breasts). This approach requires coordination of both the breast cancer surgery and plastic surgery teams. Immediate reconstruction may not always be possible if you need additional treatments such as chemotherapy or radiation therapy. In some cases, a surgeon will recommend waiting until after these treatments are finished before starting reconstruction. Or, depending on your situation, a surgeon may recommend doing part of the reconstruction immediately and then finishing the reconstruction after chemotherapy and/or radiation therapy are done. You and your surgeon can discuss your particular situation and needs.

After mastectomy or lumpectomy surgery, as well as after radiation therapy, chemotherapy, or targeted therapies that are given.

This is called delayed reconstruction. Treatments such as radiation therapy and sometimes chemotherapy given after surgery can cause the reconstructed breast to lose volume and change color, texture, and appearance. Radiation therapy in particular is known to cause undesirable changes to an implant reconstruction. Cancers that are larger than 5 centimeters and that have spread to the lymph nodes are more likely to need radiation therapy after surgery. Research also suggests that a reconstructed breast may interfere with radiation therapy reaching the area affected by cancer, although this can vary on a case-by-case basis. Some surgeons advise patients to wait until after radiation and chemotherapy are finished before having reconstruction. This means reconstruction might be done 6 to 12 months after mastectomy or lumpectomy.

Reconstruction also can be done years later if desired. Some women aren’t ready to have the surgery sooner, or they change their minds about their initial decision to “go flat” or wear a prosthesis.

As a staged approach

This involves some reconstructive surgery during mastectomy or lumpectomy and more reconstructive surgery after any additional treatments. This is also called delayed-immediate reconstruction.

The timing of breast reconstruction is one of the most discussed topics in reconstruction research. It’s important that your entire team of breast reconstruction specialists in Dallas, TX – breast surgeon, plastic surgeon, radiation oncologist, medical oncologist, and other caregivers – meet as a group and discuss your unique situation. Ideally, this group should meet before you make your decision about mastectomy or lumpectomy because the type of breast surgery you have can affect the reconstruction outcome. Together, you and your team can decide on an approach that is best for you.