Delayed-immediate reconstruction is performed when natural tissue reconstruction is desired, but it is unclear if radiation will be necessary or if a patient is at high risk for complications (e.g. from smoking), which might delay additional cancer treatment after surgery.
Delayed immediate reconstruction is a technique used when a patient’s need for radiation post-surgery is unknown until tissue can be examined during mastectomy.
Some women may need radiation treatment follow their mastectomy. That determination can often not be made until the time of mastectomy is often base on the size of the tumor and the number of lymph nodes found to contain cancer cells.. In some cases it may be preferable to delay breast reconstruction until after radiation therapy is complete, as radiation can cause damage to the breast skin and surrounding tissue.
However, that timing must be balanced with a woman’s preference to retain her own breast skin, nipple, and areola if possible. If a nipple-sparing or skin-sparing mastectomy is possible, reconstruction must begin right away in order to preserve the skin, nipple, and areola.
Delayed immediate reconstruction provides options depending on what the surgeons discover during the mastectomy. If possible, a nipple-sparing or skin-sparing mastectomy is performed and tissue is removed for examination. A tissue expander is placed, regardless of whether the final reconstruction will be implant-based or natural tissue-based.
If radiation therapy is needed, then the tissue expander stays in place and standard delayed reconstruction will occur several months after radiation is complete. If radiation is not needed, reconstruction may proceed sooner.
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