Expert: Minas T Chrysopoulo, MD - 11/1/2011

Question
Hi,
could I ask, would a breast reconstruction ever be done on the same day as a mastectomy or would this part always be done at a later date?
Also could I ask about the procedure of a mastectomy or is this not an area you answer questions on?
Many thanks Michelle

Answer
Hi Michelle,

Breast reconstruction can be performed at any time - either at the same time as the mastectomy (preferable) or any time after mastectomy.

"Immediate breast reconstruction" is the term used  to describe reconstruction performed at the same time as the mastectomy. This can be performed in conjunction with a "skin sparing mastectomy" which preserves the breast skin envelope and leaves less scarring. In some select cases nipple-sparing mastectomy can also be performed - this preserves the nipple and areola as well as the breast skin. The nipple-areola can also be reconstructed when it is not preserved.

Immediate reconstruction enables the patient to wake up from the surgery "complete" and avoid the experience of a flat chest completely. Most women with early breast cancer (stage I or II) are candidates.

We recommend immediate reconstruction wherever possible since this generally leads to the best cosmetic results.

"Delayed breast reconstruction" usually takes place several months after the mastectomy. Patients having radiation may be advised to delay the surgery for the best results. This delay may be for several months. This allows the chest tissues to heal as much as possible after the radiation. Other reasons for delaying reconstruction include advanced disease (stage III or IV) and lack of access to a reconstructive surgeon.

Here are some patient before and after photos that illustrate the difference between immediate and delayed breast reconstruction:

http://www.prma-enhance.com/index.cfm/ProcedureNameID/19/PageID/1946

Hope that info helps.

Dr C
http://www.prma-enhance.com