Delayed Breast Reconstruction 

Delayed Breast Reconstruction

Delayed reconstruction is breast restoration performed some time after mastectomy: when oncological treatment has been completed, the condition has stabilized, and the woman has made her decision. Several months or several years may pass between mastectomy and reconstruction. This does not affect the quality of the result.

Delayed reconstruction is not worse than immediate reconstruction. It is simply different. It has its own advantage: time. Time to complete treatment, regain strength, and think through the decision without the pressure of the operating room. At Iskusstvo Clinic in Moscow, surgeons understand that a woman makes this decision for herself, and they do not rush her.

Methods of Delayed Reconstruction

Reconstruction with an Expander, Followed by Implant Replacement

This is a two-stage method. First, a tissue expander is placed. It gradually stretches the tissues and creates a pocket for the permanent implant. After 3–6 months, the expander is replaced with a permanent implant.

This is a less traumatic option that does not involve the use of the patient’s own tissues.

→ More information: Reconstruction with an Expander, Followed by Implant Replacement

Reconstruction with a Combination of an Expander and a Latissimus Dorsi Flap

When the patient’s own chest wall tissues are insufficient to cover the expander, a latissimus dorsi flap is used to provide additional soft tissue coverage. This combination makes reconstruction possible in cases where an implant alone cannot be used.

→ More information: Reconstruction with a Combination of an Expander and a Latissimus Dorsi Flap

Microsurgical Reconstruction with a DIEP Flap

This is reconstruction using the patient’s own abdominal tissue without sacrificing the muscles. It is the most complex method and provides the most natural result. Abdominal tissue is transferred to the breast using microsurgical techniques.

This method is preferable in patients with a history of radiation therapy.

→ More information: Microsurgical Reconstruction with a DIEP Flap

Defect Correction Using Regional Perforator Flaps, LICAP, AICAP, TDAP

Small flaps from the lateral chest wall are used to restore partial defects or correct the breast shape after the main reconstruction. These flaps are less traumatic than large flaps and do not require microsurgery.

→ More information: Defect Correction Using Regional Perforator Flaps, LICAP, AICAP, TDAP

How the Method Is Selected

The surgeon evaluates the volume and quality of the chest wall tissues, history of radiation therapy, body type, concomitant diseases, and smoking status. In irradiated tissues, autologous reconstruction is preferable.

The patient determines her readiness for a long operation and rehabilitation, whether she wants to avoid an implant, how important a natural result is, and how lifestyle and physical activity should be taken into account.

Radiation Therapy and Choice of Method

Radiation therapy is one of the key factors. Irradiated tissues tolerate implants less well, and the risk of capsular contracture is higher.

In such cases, autologous reconstruction, such as DIEP reconstruction or a latissimus dorsi flap, is preferable. Living tissue tolerates the consequences of radiation better.

Rehabilitation

Recovery timelines depend on the method.

After expander placement, hospitalization usually lasts 3–5 days, with return to normal life in 3–4 weeks.

After DIEP flap reconstruction, hospitalization usually lasts 7–10 days, with full recovery taking 6–8 weeks.

The final result forms within 6–12 months.

Frequently Asked Questions

How Long After Mastectomy Can Reconstruction Be Performed?

As a rule, reconstruction can be performed 6–12 months after completion of all oncological treatment. This time is needed for tissue stabilization.

The specific timing is agreed with the oncologist.

Can Reconstruction Be Performed After Radiation Therapy?

Yes. After radiation therapy, autologous reconstruction using the patient’s own tissues is preferable, such as a DIEP flap or latissimus dorsi flap.

Living non-irradiated tissue can provide a good result even in this situation.

Is Surgery on the Healthy Breast Needed for Symmetry?

Often, yes. Corrective surgery on the healthy side, such as mastopexy, reduction, or augmentation, is performed as a separate stage and is included in the overall treatment plan.

Is the Implant Felt After Reconstruction?

If there is sufficient soft tissue coverage, no. After mastectomy, there is less tissue, so proper technique and implant volume selection are important.

If there is a lack of tissue, autologous reconstruction is preferable.

Book a Consultation

Book a consultation. The surgeon will explain the suitable methods and help you make a decision without rushing.