Understanding Staged Breast Reconstruction

Breast reconstruction is typically a staged procedure. That means that in most cases, patients require multiple surgeries to reach the final result. Every stage is different just as every stage is different. Read on for what types of stages patients undergo and why it is important to understand them.

Many patients do not know that breast reconstruction takes multiple steps.

Patients often report that they did not understand how many procedures would be involved during their breast reconstruction process. This happens for a variety of reasons. Most patients are in a state of extreme stress at the time of their breast reconstruction consultation, which makes it difficult to take in all the information a surgeon may provide. Surgeons also typically show before and after photos that show what a patient looked like before their first surgery and after their final surgery only. This can make it hard to process the idea that there may have been several steps in between. It is important for patients to really understand that there will almost certainly be multiple stages in their breast reconstruction for the purposes of physical and emotional planning.

Surgical stages vary by person and breast reconstruction type.

Several factors help plastic surgeons determine how many stages a given breast reconstruction will require. Those include procedure type, mastectomy type, patient body type, patient goals, and more. Natural tissue reconstruction procedures often necessitate more procedures than their implant-based reconstruction counterparts. However, implants require maintenance down the line that natural tissue reconstruction does not.

One-and-done breast reconstruction is possible in theory, but it is rarely truly feasible.

Direct-to-implant breast reconstruction is sometimes touted as a one-and-done option. Unfortunately, the reality is that that is only possible in a very small number of implant reconstruction cases. Most patients require secondary procedures, like fat grafting, scar revision, or nipple areola reconstruction, even if they undergo direct-to-implant reconstruction.

Secondary procedures tend to be smaller than initial reconstruction.

While a three, four, or five-step breast reconstruction surgery may sound daunting, the bulk of breast reconstruction cases only require one major procedure at the time of mastectomy. Subsequent surgeries are typically ambulatory with much swifter recovery periods than the initial reconstruction.

Understanding staging can help you make informed choices.

The only way to get a tangible sense of how many stages will be involved in your specific procedure is to have an in-depth conversation on surgical stages with your plastic surgeon. In some cases, patients use this information to choose a general type of reconstruction.

There is no time-table for secondary procedures—and they’re not mandatory.

Secondary or revision procedures do not need to be completed on any set schedule. This means that patients can take a break from surgeries at any point and come back when they are ready or able. Revision can also be a time for self-advocacy: just because your surgeon feels you should have an additional procedure does not mean that you need to do so. The same goes in the other direction. Remember, the goal of reconstruction is to restore your body in the way that works for you.