There are several considerations to look at in deciding on immediate/delayed breast reconstruction surgery. Among these is vascularity, or how well blood or lymph travels through the remaining tissue of the breast mound after the mastectomy. Post a mastectomy, radiation therapy can be prescribed – in this case, it would be best to wait as the implant would not take well in an irradiated tissue bed. With reduced blood supply, there is an increased change for scar tissue formation. The reverse is true – for patients not requiring radiation, immediate breast reconstruction may be better. Also there is the highly possible negative psychological impact of waking up from the mastectomy without a breast – immediate breast reconstruction would then be well timed. A more practical consideration for immediate reconstruction is that more of the natural breast skin is preserved after a mastectomy, making for a more realistic and satisfying reconstruction. But then again, there are some that may feel overwhelmed with having to make such decisions regarding their cancer treatment, believing in the adage of “one step at a time.” They will come back to their surgeons later on when they’re good and ready to do something.