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Breast Reconstruction After Breast Cancer: Important Factors to Consider

Written by Jamal Bullocks, M.D. on Apr 1, 2015 10:00:00 AM

Undergoing a mastectomy can be a physically and mentally difficult process for a patient. Because many patients opt for breast reconstruction, it is extremely important to know what the surgical options are.  

First, there are two general categories when it comes to breast reconstruction surgery: delayed and immediate.

Immediate reconstruction refers to beginning the reconstruction process at the same time as the mastectomy. Delayed reconstruction refers to reconstruction that takes place any time after the chest has healed from the mastectomy and after the woman has completed any additional cancer treatments that may be recommended.  

Why immediate reconstruction may be advantageous

Typically, there are several surgeries associated with breast reconstruction. By initiating reconstruction at the same time as mastectomy, rather than later, at least one additional surgery may be avoided. 

If the surgery is done immediately, there’s an effort to preserve as much native breast skin and tissue as we can so the resulting reconstruction can utilize the maximum amount of native skin and tissue possible. This means the reconstructed breast will look and feel more natural than one that is reconstructed in a delayed manner, largely because if reconstruction is delayed, the skin will be more contracted and scarred.

Determining suitability

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Generally speaking, most people are candidates for immediate reconstruction. However, there are extenuating circumstances when patients are not best suited for this volume of surgery at one time and delayed reconstruction would be a better option.  

For those whose disease is advanced and require extensive chemotherapy or radiation, they need a break between mastectomy and reconstruction to let their bodies heal.   

Patients with certain uncontrolled medical conditions or who are smokers or obese usually aren’t good candidates for immediate reconstruction. Because it’s sometimes difficult for these patients to heal, delayed reconstruction is a better option.  

These are all things you can discuss with your surgeon in your consultation – which is why consults are important to schedule. You need to know all of your options and be open with your doctor about what you’d like to do before deciding on anything. Then your surgeon can help you determine the best course to take and direct you to a reasonable outcome. 

Do you have questions about either of these procedures? Leave a comment below!

Dr. Jamal Bullocks is a board-certified Plastic Surgery specialist whose clinical interests include reconstructive breast surgery, cosmetic surgery for men and women and body contouring after weight loss.  

Topics: mastectomy, breast reconstruction, breast cancer

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