Breast Reconstruction Timeline: Everything You Need To Know

Breast Reconstruction Surgery Timeline

Breast Reconstruction Journey Timeline Overview

It is possible to feel empowered and confident as you decide when, where, and how to have reconstruction–or whether to have it at all. Here at Dr. Levine’s Center for Breast Reconstruction, we are with you ever step of the way from where you are today, to where you could be 3-6 months from now. It can take time to adjust to your diagnosis, results of your ever changing body, and process your feelings.

The following Breast Reconstruction Journey Timeline will give you an idea of what to expect throughout its stages, so you can be prepared, set realistic expectations, and feel organized and clear.

Breast Reconstruction Surgery typically is completed in 2-3 stages:

Stage 1: Perforator Flap Surgery – First initial breast mounds (breasts without nipples) are formed with expanders or your own tissue.

Stage 2: A later operation creates new nipples and makes cosmetic revisions to the new breasts, if necessary.

Stage 3: In a third, optional procedure, the nipples and areolae are tattooed. Dr. Levine offers nipple sparing mastectomy, which shortens the overall reconstruction timeline as in these cases there is no need for nipple reconstruction or tattooing.

For many women, nipple-sparing mastectomy combined with immediate breast reconstruction with natural tissue completes their entire reconstructive process in the quickest way: one trip to the operating room and one recovery. We’ll work with your unique case throughout the process to determine the smoothest, safest, and more beneficial step to your recovery.

Breast Reconstruction Timeline by Week / Month

Decision Making & Research Stage

During this stage of your reconstruction timeline, the following 3 questions will require your decision. Keep in mind that you can call us anytime M-F (9-5) with any questions – we are here to help you throughout this process. There are resources throughout our website to guide you in answering these questions as well.

1.) Which procedure is right for you? > View our Natural Tissue Procedures

2.) Who will perform your reconstruction? > Learn about Dr. Levine | View the What To Ask Your Surgeon Checklist

3.) When will your reconstruction be performed – at the same time as your mastectomy or later? Learn about Immediate vs. Delayed Reconstruction

Two Weeks Prior: Pre-Op Appointment

A pre-op appointment is to make sure that you are healthy enough for surgery and anaesthesia. Here, we’ll complete your bloodwork, a urinalysis, an EKG, a chest x-ray, and a basic physical. We’ll review your surgical plan, addressing any remaining questions or concerns you may have. The other essential purpose of this appointment is to support you and make you feel as rest-assured and at-ease as possible with your upcoming surgery.

Occurs two weeks before your surgery
Usually takes about 1-1.5 hours with the nurse
Review of the surgical plan with you
Remaining questions and concerns are addressed
Pre-surgery instructions are reviewed:
- Nothing to eat or drink after midnight before surgery day
- Time of arrival and directions to hospital
- Instructions for family members
Complete blood work, EKG, and chest x-ray as needed

Surgery Day (Stage One: Perforator Flap Surgery)

The Operating Room

Once inside the operating room, you will meet the anesthetist who put you to sleep for your surgery. You will be connected to numerous machines like heart and blood pressure monitors that will ensure your vital signs remain normal. Once connected, you will be put to sleep, connected to a ventilator system and fitted with a catheter.

Your Surgical Team

Our world-class surgical teams consist of highly skilled microsurgeons and breast surgeons supported by specially trained nurses & O.R. staff. Each team member plays an integral role in providing you with the highest quality care and optimal surgical results.

During Surgery

The length of your surgery depends on the type of procedure and whether one or two breasts require surgery. Most DIEP and SIEA procedures are completed in two to four hours when one breast is being reconstructed or approximately six to eight hours for both. TUG, SGAP and IGAP surgical procedures typically take approximately 6-8 hours.

First Days of Recovery

First 24 Hours After Surgery

You will be monitored closely by your members of your surgical team for the first 24 hours.

Three – Five Days Into Recovery

You will make small steps towards going home between the third and fifth day after surgery. You may be released as early as the third day depending on your ability to move around and manage your drainage tubes.

Follow-Up Appointment (Within 1 Week of Surgery)

To ensure your healing and recovery are a perfect success, most patients will see their breast reconstruction team a minimum of four times after surgery.

After Surgery Care: 0 - 8 Weeks

As you move into weeks four-eight after your initial perforator flap reconstruction, you’ll begin taking increasing strides towards normal activity. Restrictions such as keeping your shoulder movement and arm levitation to a minimum will become less necessary as you heal.

Most patients may return to work four to six weeks following a breast reconstruction surgery. Note – If your job requires physical exertion, more time may be needed.

Second Stage Surgery

After recovery there will typically be one more small surgery either to reconstruct nipples, refine or revise the breast reconstruction, and/or refine or revise the donor site.

This surgery is usually about 2-3 months after the breast reconstruction.

Recovery (6 Weeks - 3 Months)

Following your second stage surgery, you’ll begin on your path towards full recovery. Keep in mind increased tension on the incision may cause your scars to stretch, so a proper supportive bra should be worn until your scar fully matures, which may take up to a year. Some swelling of the breast and donor site is normal. No restrictions on lifting, but start slowly as your muscles will be weak. You may begin to do normal household activities again (example: laundry and vacuuming). You may resume sexual activity. You may increase your general activity level (example: swimming or working out at the gym). If after three months you are not back to your normal activities, ask your doctor for a referral to a physiotherapist.

3 Months (Nipple Tattooing / Reconstruction)

After nipple reconstruction and when all of the incisions are totally healed, tattooing is done to re-create the normal color of the nipple areola complex. This is a minor procedure done in the office, and it takes about an hour.

This is done by a tattoo specialist in medical tattooing.

Note: Nipple Sparing Mastectomy:

Many women are now opting to have nipple sparing mastectomy (NSM). In these cases there is no need for nipple reconstruction or tattooing.

6 Months

Six months later, with us by your side along your healing journey, you can find yourself getting back to your life. Drive where you please. Lift what you please. Travel where you please. Be who you please. At this stage in the game, you’ll be recovered, and in that recovery, will have the warm, natural shape of your breasts back.