Breast reconstruction can be performed at the same time as the initial Mastectomy procedure (referred to as Immediate Reconstruction) or at any stage at a later date (referred to as Delayed Reconstruction).
Immediate Reconstruction is often possible and will be discussed with the patient if a mastectomy is indicated. It is now an option that should be offered to all patients having a mastectomy as long as it is clinically appropriate.
In cases of locally advanced or aggressive breast cancer, it may be preferable to have a Mastectomy alone and consider a delayed reconstruction after completion of systemic therapy. Immediate reconstruction may also be inappropriate for women with multiple health issues which increases the risk of complications.
Various techniques of breast reconstruction are available and these are broadly categorised into 3 groups: Implant reconstruction, Lat Dorsi Flap reconstruction (the use of back muscle) and TRAM/DIEP Flap reconstruction (the use of abdominal fat).
The optimal technique will depend on various factors which include breast size and shape, body weight, available tissue, level of physical activities, radiotherapy and previous breast or abdominal surgery. Smoking is associated with a higher risk of complication and patients are advised to stop smoking far in advance.
An optimal technique for one patient may not be suitable for another. You will be counselled regarding the pros and cons of each technique, its suitability and the need to have an appropriate level of expectation. It is not uncommon for a patient to require at least 2 operations to achieve a satisfactory symmetry.