The Pros and Cons of Delaying Breast Reconstruction Surgery During the COVID-19 Pandemic

The development and spread of the novel coronavirus has forced all elective medical procedures to take a backseat to care that is deemed essential — or lifesaving – to keep people from contracting COVID-19.

One of those procedures, reconstructive surgery following breast cancer, has all but come to a screeching halt.

In an interview with CURE®, Dr. Jonathan Bank, a board-certified plastic surgeon at New York Breast Reconstruction and Aesthetic (NYBRA) Plastic Surgery, discussed the pros and cons of delaying breast reconstruction surgery for an unknown period due to COVID-19.

“In terms of the reconstruction, there are pros and cons to doing reconstruction in different time sets,” Bank, who specializes in breast reconstruction after cancer, said. “For instance, in the case of mastectomy or a bilateral mastectomy there are many benefits to performing an immediate reconstruction.”

The advantages of an immediate reconstruction, according to Bank, include preserving the natural skin envelope, the skin remains soft and has its natural shape.

“Psychologically, there’s huge advantage in performing an immediate reconstruction,” he said. “Now, that’s not to say delayed reconstruction is not an option. It's absolutely an option. But you're starting off with a slight disadvantage.”

Although there are advantages to having reconstructive surgery immediately, there are also benefits to waiting and spacing out surgeries in patients who may have already started the reconstruction process before the spread of COVID-19.

“That includes the tissue that was operated on, the skin, the fat underneath the skin, everything goes through a healing sequence that just takes time to calm down,” he said. “Actually, the longer you wait the better off you are in terms of the palette that you are now working on. If you operate too soon, things may still be swollen, they may not be as supple and easily managed surgically.”

Bank assures patients not to worry about having to push off those follow-up reconstructive surgeries. The tissue expanders that may have been originally placed can stay in the body for years, he said.

“It's not the most comfortable thing in the world, it definitely throws a wrench in life planning, but again in a risk-benefit balance, there is no problem to wait just to be safe,” Bank concluded.