Breast Reconstruction Timing of the Procedure - Reconstructive Options - Frequently Asked Questions The current lifelong risk of breast cancer for women in the United States is one in eight. Despite advances in breast conservation therapies, mastectomy remains an important tool in fighting this disease. For many patients breast reconstruction is chosen to restore body image and allows the patient to feel "whole" again. Breast reconstruction is a process, requiring several operations to arrive at the final result. Preferably the patient consults with the plastic surgeon prior to her mastectomy so that these stages can be thoroughly discussed and so that she may have an understanding of what she can expect. Timing of the Procedure Back to Top Breast reconstruction can be "immediate" or "delayed". In other words, the reconstructive process can begin at the time of the mastectomy or at a later date after the mastectomy has completely healed. Studies would suggest that there is a psychological advantage to immediate reconstruction as the patients grief associated with the loss of her breast is lessened. Additionally, immediate reconstruction spares the patient a separate operation for the first stage of reconstruction. Some patients are not ideal candidates for immediate reconstruction, however, if there is a high likelihood that they will require postoperative radiation or chemotherapy. Reconstructive Options Back to Top The technique of breast reconstruction can be generally divided into autologous and implant reconstruction. Autologous reconstruction involves re-creation of a breast mound with the patient's own tissues, generally from the abdomen or the back. Excess fatty tissue and skin are transferred to the chest to re-create a breast based upon the blood supply to abdominal muscles or back muscles. The primary advantages of autologous reconstruction are that the breast is reconstructed from the patients own tissue and it is easier to recreate "droop" to match the opposite breast. The trade-off is that these operations are longer, more technically demanding procedures with increased postoperative pain, a more difficult recovery period, and a higher complication rate. For these reasons Dr. Yates and his patients prefer implant reconstruction in most cases when able. The first stage of this technique involves placement of a tissue expander which gradually stretches the skin re-creating a breast mound. The second stage involves removal of the expander and placement of a permanent implant. Oftentimes the patient would benefit from a procedure on the opposite breast for symmetry including; mastopexy, breast reduction or breast augmentation as indicated. In the third stage, a nipple is reconstructed which is later pigmented to match the opposite breast with tattoo. Frequently Asked Questions Back to Top Does insurance pay for breast reconstruction? Yes. All insurance providers are required to pay for breast reconstruction including opposite breast surgery as necessary for symmetry. What risks are associated with the procedure? Dr Yates will thoroughly discuss the rare but potential risks at the time of your consultation.