Thank you for your question!
I hope you are recovering well from your mastectomy. There are basically 2 forms of breast reconstruction available to you: use of your own tissue (autologous reconstruction) or implant-based reconstruction.
I assume from your question that you are mainly looking at implant-based reconstruction. This is a good option provided that the original mastectomy did not require the removal of the pectoralis major muscle and you do not require radiotherapy to the breast. The success of implant-based reconstruction depends very much on the quality of the soft tissue envelope overlying the implant, ie. muscle and skin/fat.
To answer your question succinctly, there are 2 factors that would impact on your timing of delayed breast reconstruction: the need for adjuvant therapy (chemo-, hormonal and/or radiotherapy) as well as your health and wound status.
Personally, I would wait for the completion of any chemotherapy before placing an implant expander. A minimum of 3 weeks is my preference after cessation of chemotherapy to consider reconstruction. Chemotherapy results in poorer wound healing and can cause problems with both the implant and the expansion process.
Hormonal therapy on the other hand can be carried out concurrently. Implant expanders allow for a single stage reconstructive process without the need for a staged expander removal and implant insertion.
I hope this answers your question.
Best Regards,
Dr. Samuel Ho
