Benefits
Breast reconstruction offers the opportunity to restore the natural shape and symmetry of the breasts.
This means feeling whole, confident, and more comfortable in their clothing, in moments of intimacy, or simply when looking in the mirror. In cases where only one breast is removed, reconstruction can also address the discomfort and physical strain caused by the asymmetry and physical imbalance.
Combined Procedures
Breast reconstruction can be combined with lymphatic reconstruction surgery to avoid arm swelling, or nerve reconstruction to restore breast sensation.
When the flap is taken from the abdomen, it can be combined with abdominoplasty for body contouring.
Reconstruction Timeline
Breast reconstruction involves multiple stages over 6–12 months, depending on the type of procedures and whether you need other cancer treatments in between.
-
1.
Initial Reconstruction Surgery
Implant, flap, or device to expand skin and prepare for future implants. -
2.
Chemotherapy / Radiotherapy
If needed, cancer treatment takes place between reconstruction stages. -
3.
Revisional Surgery (3 months after)
Refining shape, injecting fat for smoother texture, balancing procedure on the other breast (reduction, lifting, or augmentation). -
4.
Nipple and Areola Reconstruction (3–4 months later, variable)
Nipple and areola reconstruction or tattooing to complete the final appearance.
Timing of the first reconstruction
Immediate Reconstruction
Pros
- Minimizes the psychological impact of not having breasts, even if temporarily (Roy et al., 2024);
- Better cosmetic results (the surgeon can preserve breast skin and nipple)
Faster recovery; - Fewer number of surgeries and lower cost.
Cons
- Having post-operative chemotherapy, radiotherapy, or cancer recurrence can affect the reconstruction results (Thamm & Andree, 2018)
Delayed Reconstruction
Pros
- Avoids interference between reconstruction results and post-operative chemotherapy/radiotherapy (surgery is delayed after treatment is completed);
- Since most cancer recurrence occurs in the first 1-2 years, delaying reconstruction ensures the patient is free of cancer to optimize the reconstruction results;
- You have more time to weigh your options and make your decision.
Cons
- Psychological impact, due to the temporary lack of breasts;
- Scar tissue from breast removal surgery makes reconstruction more challenging and limits your options;
- Cosmetic results may not be as optimal as immediate reconstruction (less skin is remaining) (Thamm & Andree, 2018; Yoon et al., 2018).
How to choose the right timing for you
Determine your goal
- For faster result → Immediate
- For more stable results → Delayed
Understand your cancer treatment
- Post-operative radiation → Delayed (immediate can be done only with flap but will still carry a higher risk of complications)
- Post-operative chemotherapy → Immediate reconstruction is possible (but if complications happened, it will delay your chemotherapy)