The Decision of “When” in Breast Reconstruction
Timing can be everything when it comes to optimal breast reconstruction. Our patients have every available option in choosing services with Dr. Levine.
Breast reconstruction can be done immediately after a mastectomy during the same operative session or can be delayed until months, if not years, later. The decision of “when” is highly personal with factors to consider with your treating physicians. The following are reasons why women may elect to reconstruct their breast(s) at the same time as mastectomy (immediate breast reconstruction) or postpone to a later time (delayed breast reconstruction.) or facilitate a combination of the two (staged-immediate).
- Immediate – Breast reconstruction is done at the same time as mastectomy with one of our expert breast surgeons.
- Delayed-immediate or Staged-immediate – Breast reconstruction is done separately, generally within two weeks of mastectomy.
- Delayed – Breast reconstruction is done at ANY time after mastectomy or partial mastectomy or following prior reconstructive efforts, i.e. failed breast implants.
Benefits of Delayed-immediate or staged-immediate Breast Reconstruction
In some cases, patients may derive some benefit from having their natural tissue breast reconstruction within one to two weeks after mastectomy. We call this delayed-immediate or staged-immediate breast reconstruction. Using this protocol provides the patient with the following advantages:
- The patient may keep her current team of healthcare providers and hospitals for oncological care and mastectomy surgery. Patients often prefer keeping their trusted breast surgeon and receiving continued care in a familiar environment that may be more convenient. In choosing the delayed-immediate protocol, our patients can have true muscle-sparing, natural tissue breast reconstruction with Dr. Levine AND keep their current breast care team.
- When the patient has elected nipple-sparing mastectomy (NSM), the delayed-immediate approach increases the likelihood of nipple survival. This is because the nipple is traumatized during NSM surgery. Thus, delaying further surgery allows the nipple time to recover without further stress of continued manipulation.
- This protocol provides time for final pathology results to be received prior to breast reconstruction. This affords the patient and treating physician(s) the opportunity to make key decisions regarding further treatment that may be recommended. This also provides for optimal strategy, planning, type and timing of breast reconstruction.
- The reconstructive surgery will be quicker since the mastectomy has been completed.
Why immediate breast reconstruction?
- fewer surgeries with mastectomy and breast reconstruction in same OR session
- may result in better cosmetic outcome
- nipple-sparing mastectomy chosen
- may offer quicker emotional recovery
- may offer quicker overall recovery
Why delayed breast reconstruction?
- medical treatments such as radiation therapy
- smoking cessation required (perforator flaps)
- improve current health status
- prefer to heal first from breast cancer diagnosis before making decisions regarding reconstruction
- recovery time planning
- uncertain of best personal option
- personal preference
There is no right or wrong answer in which is best as far as timing for breast reconstruction. Whether you choose immediate or delayed breast reconstruction, you can still obtain natural looking and feeling breasts through natural tissue breast reconstruction.
TESTIMONIALS FROM DR. LEVINE’S PATIENTS
I wanted you to know how grateful I am for the use of your lab coat to cry on that one day in my hospital room. As much as I appreciate professionalism in my doctors, I value you more human nature’s willingness to be compassionate and understanding. Thank you for your arms of kindness and car that day. The days before me seem so much brighter than they have in the past years. Belssings! Jeannine