Many women who have a mastectomy—surgery to remove an entire breast to treat or prevent breast cancer—have the option of having more surgery to rebuild the shape of the removed breast.
Breast reconstruction surgery can be either immediate or delayed. With immediate reconstruction, a surgeon performs the first stage to rebuild the breast during the same operation as the mastectomy. A method called skin-sparing mastectomy may be used to save enough breast skin to cover the reconstruction.
With delayed reconstruction, the surgeon performs the first stage to rebuild the breast after the chest has healed from the mastectomy and after the woman has completed adjuvant therapy.
A third option is immediate-delayed reconstruction. With this method, a tissue expander is placed under the skin during the mastectomy to preserve space for an implant while the tissue that was removed is examined. If the surgical team decides that the woman does not need radiation therapy, an implant can be placed where the tissue expander was without further delay. However, if the woman will need to have radiation therapy after mastectomy, her breast reconstruction can be delayed until after radiation therapy is complete.
Breasts can be rebuilt using implants (saline or silicone) or autologous tissue (that is, tissue from elsewhere in the body). Most breast reconstructions performed today are immediate reconstructions with implants.