Immediate or delayed reconstruction?

I am due to have a mx on Thursday. I have been offerd immediate reconstruction, using an implant. This is not the normal pracise of my hospital but as my consultant is on holiday a consultant is coming from another hospital who has offered this. If I opt for the immediate reconstruction this will delay my surgery by 1 to 2 weeks.

I’m very unsure which to go for. It is unclear whther I will need radio and won’t be known until results after surgery - I know this can affect the implant and skin if I need it. But the prospect of getting all major surgery done together is appealing.

Has anyone had an immediate reconstruction then radio? Would you make the same choice again?

Any advice at all? I am really up against it in terms of making a ecision and feel very confused - thanks

I saw some women following this kind of treatment - her boobs looked terrible. It would be better without any reconstruction.

Hi Leedslass

I had an immediate LD flap recon with implant and have just finished rads. This was a calculated risk I took. The implant won’t affect the effectiveness of the rads, but it is quite likely that the rads will affect the implant - my plastic surgeon said that even if get capsulation round the implant and, worse case, down the line I need the capsulation removed and a new implant (happens in about 30% of cases within 5 years), the final cosmetic result will still be better than a delayed recon.

If I am going to get capsular contraction it won’t start to show for a while - my PS said it can take up to a few years before it gets that bad that you need it removing and a new implant.

My recon boob is slightly bigger that the other, and I have a port in the implant where they can pump it up or let it down, so I’m hoping that if I only get minor shrinkage and contraction, they can let it down a bit and that will do the job.

I still don’t regret my decision to have an immediate recon. Various studies have shown that we can do better mentally and physically, and even if I do need to have another op, it’s a small one compared to a full delayed recon.

However, if it is an implant only recon you are being offered, according to my PS, that is a different story. If you have rads, you will almosr certainly get capsulation and the damage that that’s done can make a correction/full recon more difficult.

A difficult decision - maybe ask to talk to the consultant again with more questions about the pros and cons of the particular op he is offering you?

Good luck.

By the way, while I would much rather have my ‘real’ boob, my recon one looks pretty good!

I had an immediate LD recon without implant - my PS won’t use implants pre-rads for the reasons listed by DJ above - and it looks absolutely brilliant. Not quite the same as the real thing, and still have some ‘finishing touches’ to be done, but I was thrilled to wake up and find a cleavage! (I am quite well endowed).

It was uncomfortable at the time of surgery but never painful. I have lost a bit of strength on the affected side but that’s partly about my own reluctance to overuse the arm.

I knew that if I didn’t do it there and then I *probably* never would. Absolutely no regrets, it was right for me. And you will decide what is right for you.

Hi RevCat

Did you have an LD flap without an implant?

I only ask because i had this procedure on Monday, without the implant, and it although it is all bandaged up at the mo, i can tell that is quite flat.

I did have an implant previously, but it burst through the skin, so PS felt it would be safer to leave it out for a few weeks to avoid infection.

Just wondered how yours looked without the implant.


Given the choice I would have loved to have an immediate recon … but they didn’t know if I would need rads … so it was decided best not to. As its turned out, I dont need rads … but even so … planning the recon next year … give me time to get fit and healthy before more surgery. And I haven’t found wearing the prosthesis and not having a boob a problem to be honest. The chemo and losing hair was by far the worst thing to happen.

Hi Naz,
I had no implant, my PS won’t use implants if you are going to need rads. My recon is a lovely ‘generous C cup’ and in due course my healthy side will be reduced to match. Again, my PS insisted I wait 4 months after end of rads for things to settle before she’d decide what to do - seeing her in two weeks to find out!

I guess it depends on exactly how they did the surgery and how much muscle you had to start with? My PS recons she can get a B to C cup for most people.

Hope all is well and you soon get to see a new, and beautiful, of not as lovely as before, breast.

That is interesting Revcat, you do sound very pleased with your results.

Well i was about a 34d after the last recon, so i am guessing that the implant will match that size eventually.

I am seeing my ps tomorrow, so i will ask and find out what size he thinks i will be at the end of everything.

Thanks once again.


Given the choice between recon and not I would definitely go for the immediate recon. I had mine 6 years ago - tram flap - I never felt as though I had had a mastectomy and it has been fantastic. I didn’t have radiotherapy at the time but have just finished a course of radiotherapy due to recurrentce. I finished a week ago and apart from a little pinkness/itching on the edges there have been no side effects and the recon seems fine

Good luck with your decision

k x

I am having a delayed reconstruction as I may need rads. I had my mx last week and am still getting used to the new look. Hope to have a reconstruction next year using an implant

Hi there. I had immediate recon last November, at the time I didn’t need rads but after chemo my oncologist gave me the option to have rads if I wanted! I went ahead and had 5 weeks of rads because of the implant. I am very pleased with the results. It was important to me to go into surgery with two breasts and wake up with two. It helped me with my Overall recovery. I’m seeing the ps this week as I need an uplift and reduction on my other side and a new nipple. It was the right thing for me. I asked my ps to look at pictures of surgery that he’d done and it helped me understand exactly what to expect.

Good luck with your decision xx