A patient facing the diagnosis of breast cancer is devastated.  Their life suddenly is turned on end.  So much to consider. Scary decisions. Scarier thoughts: “Will I survive to see my son’s wedding?” And then the decision as to what procedure to select after being given a mountain of usually incomprehensible  data. Often a patient may simply elect to have the mastectomy and not even consider breast reconstruction because the options are just too daunting.  The patient concludes, ‘’just get rid of the cancer.  I don’t care what it looks like.” 

And she recovers after the mastectomy or lumpectomy and receives possible chemo and maybe even radiation therapy. And she is a survivor. And she starts to think about herself and how she looks.  And this is the patient that is a candidate for delayed reconstruction. 

As long as there are no physical or medical reasons as contraindications, the patient is then counseled on the possible options.  These include implant-based or autologous reconstruction (using tissue from your own body to reconstruct the breast). Delayed reconstruction requires opening up the original healed scar and elevating the skin and the tissue found just below in order to view and measure the defect that resulted from the original mastectomy. This is another step required that would not be needed during an immediate reconstruction.  But after this step there are really no limits as to how a breast can be created and should look quite similar to an immediate reconstruction.  At the same time, the uninvolved breast could be addressed in terms of matching to the reconstructed side.  This could be a breast reduction, mastopexy (a breast lift), or some combination, sometimes even with an implant to achieve the best cosmetic match.  Bilateral reconstructions have the advantage of the symmetry of doing the same reconstructive procedure on both sides. 

The benefits include restoring a patient’s sense of completeness.  The reconstruction restores that which was taken away and instills a confidence and sense of ‘I am more than a cancer diagnosis!’

Delayed reconstructions are covered by most insurance plans, including the symmetrizing procedure on the other breast, if desired. When considering delayed breast reconstruction, you may want to review your coverage with your physician and insurance company. Some insurers require a second opinion before they will agree to pay for a surgery.