Mastectomy with immediate reconstruction

In a mastectomy with immediate reconstruction, the surgeon removes breast tissue and completes the reconstruction in one operation. 

First, the breast tissue is removed to get rid of the cancer cells. The surgeon keeps some or all of the skin. This is a ‘skin-sparing mastectomy’. 

Sometimes they may be able to keep the nipple and the skin around the nipple (‘areola’). This is a ‘nipple-sparing mastectomy’.

Then, during the same surgery, they complete the breast reconstruction. You may decide to use an implant or tissue from another part of your body. 

Before you have a mastectomy, think about whether you want a breast reconstruction. If you do, it’s important to talk to your surgeon about:

• which type of breast reconstruction you want
• whether you want immediate reconstruction or delayed reconstruction.

Advantages of immediate reconstruction

If you have a breast reconstruction at the same time as the mastectomy, the benefits include:

• You will have a reconstructed breast when you wake up after surgery.
• Some people find it helps them to cope better with the loss of a breast.
• You need fewer operations, and there may be less scarring.
• It may help improve your body image and sexual wellbeing.

Disadvantages of immediate reconstruction

The disadvantages of immediate reconstruction after mastectomy include:

• You may have less time to make a decision than you would like.
• Radiotherapy after surgery can cause the skin to become darker and make the tissue more firm and dense. This can affect the look of the breast.  
• You may need more time after to recover after more complex surgery.
• You may need more surgery later, to make the breast look as good as possible cosmetically.
• If you have complications after surgery you may need to delay treatment such as chemotherapy or radiotherapy.