After you have had a mastectomy and are either beginning radiation or getting to the completion of it, you might be wondering when you can have breast-reconstruction surgery. The answer really depends on your situation and what your doctor feels is best for your recovery. There are some options open to you, however.
During the Mastectomy Surgery
It may be possible to have breast-reconstruction surgery at the same time as the surgery to remove the breast. Your cancer surgeon will finish removing the breast and any existing cancer in the area, and then a plastic surgeon will step in and either use tissue from another area of the body or use an implant to recreate the breast. This is called immediate reconstruction, and most of the work is done during one operation. This surgery may not be possible if you need further treatments such as chemotherapy or radiation.
After Further Treatments
If a surgeon reconstructs the breast immediately after a mastectomy and before you have radiation or chemotherapy treatments, there is a possibility that the breast will end up losing volume and will possibly change texture and appearance. This is the reason most plastic surgeons will wait until after radiation or chemotherapy treatments to do the reconstruction. There is also the possibility that the implants might interfere with radiation treatments, so for the most part, especially with cancers that have spread or are fairly large, doctors will wait until all treatments are done before proceeding with breast reconstruction.
With a Staged Approach
This is a newer approach to breast reconstruction, and it entails a combination of immediate reconstructive surgery and the delayed approach. This approach entails a tissue extender or even a breast implant inserted under the chest muscle after the breast is removed. This extender will temporarily help keep the breast's shape during radiation treatments and help to prevent further surgeries to expand the skin when the breast-reconstruction surgery will occur. Once radiation is complete and the tissue has recovered, the extender will be removed, and the permanent breast reconstruction will take place.
In some cases, it may be possible to have immediate reconstruction surgery, even if you are scheduled to have chemotherapy treatments. If the goal is to shrink the cancer to a more manageable size, the doctor may perform a skin-sparing mastectomy, which preserves as much of the breast's skin as possible. Your doctor will inform you if this is a possible option for you.