Secondary Breast Reconstruction
In delayed or secondary breast reconstruction, the procedure is performed at any stage following the ablative surgery, in which part or all, of the breast was removed. The timing of delayed reconstruction can be very variable but patients are usually advised to wait at least until 6 months following their last chemotherapy or radiotherapy session. From that point onwards, one can choose when to perform the procedure. It may even be several years later.
One important advantage of delayed reconstruction is that the tumour type, staging and the prognosis are known by the oncologist, surgeon and patient. This information can influence the decision to proceed with reconstruction. The patient has also had an opportunity to choose a plastic surgeon, the type of reconstruction and plan her surgery.
The benefits of a delayed reconstruction include:
- The results of the microscopic examination of the tumor (histopathology) are clearly known, providing insight into the staging and prognosis of the disease.
- The patient has had an opportunity to choose a plastic surgeon, the type of reconstruction and plan her surgery.
- Patients who undergo delayed reconstruction frequently have more realistic expectations about the aesthetic result that can be achieved.
The disadvantages of a delayed reconstruction are:
- Some patients find coping with the loss of a breast(s) difficult and experience more psychological morbidity.
- At least two hospital in-patient stays are required, including surgery and anaesthesia on both occasions.
- There is an increased total cost for both the patient and health insurance company (either private or national health service).
There is the potential risk of complications on two separate occasions.
Tertiary Breast Reconstruction
If a patient has already undergone a breast reconstruction with unsatisfactory results, a tertiary reconstruction can be planned. During this surgical procedure the previous reconstruction is removed and a new reconstruction performed.