Timing of Breast Reconstruction

You may have a choice of when to do your reconstruction.

Immediate breast reconstruction is done at the same time as the mastectomy. Right after the surgeon removes the breast tissue, a plastic surgeon puts in a breast implant. The implant is placed either on top of or under the muscle on your chest. A skin graft or an absorbable mesh holds the implant in place.

Delayed breast reconstruction is done after the operation to remove the breast cancer. If radiation treatment is needed reconstruction may be delayed until the treatment is done.

Implants do have some risks. Talk with your surgeon about long-term safety. The Food and Drug Administration offers a Risks and Complications of Breast Implants guide.

• You have trouble coping with the cancer treatment.
• You have other health issues.
• If you smoke, it is best to quit smoking before reconstructive surgery to allow for better healing. Talk with your healthcare team and refer to the ACS Quit Smoking before Surgery resource.
• You need radiation therapy. Radiation treatment can cause delayed healing and scarring.

For more information about breast reconstruction, visit the American Society of Plastic Surgeons site or The Aesthetic Society.

Keeping You Informed

In the United States, a federal law called the Women’s Health and Cancer Rights Act (WHCRA) sets requirements for insurance companies to cover reconstruction after mastectomy. Requirements apply to both the affected breast and the unaffected breast when reconstruction is performed for symmetry. Other care is also provided under WHCRA, such as breast prostheses and lymphedema management.⁵⁶ The website for The National Cancer Institute has more information.