Timing of breast reconstruction refers to breast reconstruction being performed at the time of mastectomy (immediate) or after mastectomy (delayed). Sometimes there might also be a combination called 'immediate delayed' where skin preservation involving a tissue expander is placed in preparation of reconstruction at a later date.
The timing of your breast reconstruction will be a decision made between you and your surgeon and is dependent on several factors including the type and stage of your breast cancer, availability of facilities for the surgery, availability of surgeons for the procedure, the preference of your surgeon and sometimes your personal preference.
Other than the medical reasones around timing, one practical thing to consider about timing is that immediate breast reconstruction must be done within the timing suitable for your mastectomy to treat the breast cancer. Delayed procedures will involve a waiting time in the public system up to several years as your cancer treatment mastectomy will already have been performed.
The timing of your breast reconstruction will be a decision made between you and your surgeon and is dependent on several factors including the type and stage of your breast cancer, availability of facilities for the surgery, availability of surgeons for the procedure, the preference of your surgeon and sometimes your personal preference.
Other than the medical reasones around timing, one practical thing to consider about timing is that immediate breast reconstruction must be done within the timing suitable for your mastectomy to treat the breast cancer. Delayed procedures will involve a waiting time in the public system up to several years as your cancer treatment mastectomy will already have been performed.
DELAYED BREAST RECONSTRUCTION Delayed reconstruction is completed after mastectomy or lumpectomy surgery, as well as after radiation therapy, chemotherapy, or targeted therapies that are given. Treatments such as radiation therapy and sometimes chemotherapy given after surgery can cause the reconstructed breast to lose volume and change colour, texture, and appearance. Radiation therapy in particular is known to cause undesirable changes to an implant reconstruction. Cancers that are larger than 5 centimeters and that have spread to the lymph nodes are more likely to need radiation therapy after surgery. Research also suggests that a reconstructed breast may interfere with radiation therapy reaching the area affected by cancer, although this can vary on a case-by-case basis. Some surgeons advise patients to wait until after radiation and chemotherapy are finished before having reconstruction. This means reconstruction might be done 6 to 12 months after mastectomy or lumpectomy. Reconstruction also can be done years later if desired. Some women aren’t ready to have the surgery sooner, or they change their minds about their initial decision to “go flat” or wear a prosthesis. Delayed reconstruction worked for me because I wanted the time to properly take in my breast cancer diagnosis. It also gave me time to consider all my options for breast reconstruction. While I did spend a long while with just one breast, I am now so happy with my choices and i feel like I am all back in one piece. Benefits of delayed breast reconstruction:
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IMMEDIATE BREAST RECONSTRUCTION Immediate breast reconstruction means reconstruction is done as soon as the breast is removed by the breast cancer surgeon. The plastic surgeon reconstructs the breast either with tissue from another location on your body or with an implant (and sometimes both). Nearly all of the work is done during one operation, and you wake up with a rebuilt breast (or breasts). This approach requires coordination of both the breast cancer surgery and plastic surgery teams. Immediate reconstruction may not always be possible if you need additional treatments such as chemotherapy or radiation therapy. In some cases, a surgeon will recommend waiting until after these treatments are finished before starting reconstruction. Or, depending on your situation, a surgeon may recommend doing part of the reconstruction immediately and then finishing the reconstruction after chemotherapy and/or radiation therapy are done. You and your surgeon can discuss your particular situation and needs. If you’re having prophylactic mastectomy — mastectomy to reduce a high risk of breast cancer — then reconstruction is always done immediately. "I just could not contemplate waking from surgery with no breasts. i am so grateful for the opportunity to have an immediate breast reconstruction. It was a very long surgery and recovery but I am so pleased to have taken this path. It is especially good that I could save my breast skin, so i feel like I haven't lost as much." Benefits of an immediate reconstruction are:
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