Regardless of when you may have had your mastectomy, natural breast reconstruction is available to most women.
The correct timing of reconstruction is determined on a case-by-case basis by the patient and their team of physicians (their plastic surgeon, breast surgeon, oncologist, and radiologist).
“Immediate breast reconstruction” is performed on the same day following mastectomy; this requires a longer operative time and recovery period after this initial surgery. “Delayed breast reconstruction” can be performed weeks, months, or years after mastectomy, involving a shorter surgery and recovery time. The decision to have immediate or delayed reconstruction is determined by examining a patient’s health, treatment plan, and personal situation.
The need for radiation can determine the correct timing for a patient’s reconstruction because radiation can cause complications if performed after immediate reconstruction. While this treatment damages cancer cells, it also injures the surrounding healthy tissue. As a result, this negatively affects reconstruction results by altering the texture and appearance of the newly restored breast.
Women with stage I or II breast cancer are good candidates for immediate reconstruction because they are less likely to require radiation. It’s more common for stage III or IV patients to need radiation, so delayed reconstruction is often recommended.
Along with a patient’s cancer stage, their overall health can affect the choice to have immediate or delayed breast reconstruction. Those with certain medical conditions may need to wait until after their mastectomy to have reconstructive surgery; this decision reduces the risk of complications and increases the likelihood of successful results.
Women with health issues, including diabetes, circulatory problems, or bleeding disorders, often have healing complications after surgery. A more extensive operation that includes both mastectomy and reconstruction can exacerbate these problems. These patients are advised to wait until they have fully recovered from their mastectomy to have breast reconstruction.
Patients with a high BMI (30 or higher) are more likely to have complications from breast reconstruction surgery when compared to those with a lower BMI. These complications include surgical risks such as delayed wound healing, infection, and flap failure. To reduce the chance of these problems occurring, physicians often advise a certain amount of weight loss before pursuing breast reconstruction surgery.
Smoking impedes the recovery process, increasing the risk of complications that can result in partial or total flap loss. This can increase the possibility of blood clots and wound infection by thickening the blood and weakening the immune system.
Nicotine causes blood vessels to constrict, and the carbon monoxide in cigarette smoke lessens the amount of oxygen in the blood. This can lead to healing complications because the blood vessels aren’t able to supply enough blood and oxygen to the flaps. Because of these risks, patients are required to quit smoking and pass a nicotine test before surgery.
Those who previously received reconstruction can revisit their options long after their initial surgery. Whether they had complications or disappointing results, women who’ve had alternative procedures (i.e., implants, TRAM flaps, or Latissimus Dorsi flaps) are often still candidates for delayed natural breast reconstruction.
The availability of qualified plastic surgeons and facilities can also determine when a patient will have surgery. Natural breast reconstruction surgeries are specialized procedures, so they should only be performed by board-certified physicians with extensive experience in this field.
This type of reconstruction requires two qualified plastic surgeons—and a breast surgeon if the patient is having immediate reconstruction. To work together, all these surgeons need to have operative privileges at the same hospital.
Unfortunately, some women may not have the opportunity to receive reconstruction immediately because their area doesn’t have the required physicians and/or facilities. A delayed reconstruction is a good option for those who need or choose to have their mastectomy right away and don’t mind waiting until they find a skilled surgical team that meets their expectations.
The timing of breast reconstruction can also depend on you—not just the advice of your physicians or the health aspects we previously discussed. While these factors are important, your perspective is just as valuable when making this decision.
With all the choices you are making during your breast cancer journey, reconstruction may feel like another one you have to make right away. However, it is okay to wait, and it’s very possible to come back to this decision later and allow yourself to focus on one treatment at a time.
Delayed reconstruction can also allow you to do further research and learn more about your options before making decisions. You can receive opinions from multiple plastic surgeons after your mastectomy, to ensure you are making the right choices for you.
The timing of your reconstruction can also depend on your current priorities and your ability to commit to the recovery time and process of breast reconstruction immediately. Some women are not able to devote time to another surgery after their mastectomy, and some are just not ready to take this next step right away.
Whether immediate or delayed, natural breast reconstruction provides excellent, long-lasting results. The priority is making the choices that will provide the best short-term and long-term outcomes for you.
To learn more about your options, feel free to contact us at The Center for Natural Breast Reconstruction. We are happy to speak with you via chat on our website or by email at info@naturalbreastreconstruction.com
To learn more about your reconstruction options, visit our website, talk with us via chat, or email us at info@naturalbreastreconstruction.com. We can’t wait to help you with this new and exciting chapter in life! [contact-form-7 id='19217' title='Blog_ContactForm']
