Some additional important points:
"Immediate" vs "delayed" breast reconstruction simply describes when the breast reconstruction process begins. Most approaches require more than 1 surgery and the whole reconstruction process can take several months to complete regardless of when it starts. The benefits of immediate reconstruction (same time as the mastectomy) include avoiding the experience of living without a breast, less scarring and better cosmetic results (especially when combined with nipple-sparing mastectomy). You can see patient before and after pictures here.
Many of the above procedures are often combined. For example, tissue expanders or implants can be used in conjunction with flaps. The most common combination is a tissue expander with a latissimus ("lat") flap. Fat grafting is also frequently used in combination with any of the above techniques to address contour deformities, hide implant rippling, add volume, or simply make the results more "natural".
Unfortunately, many of the above procedures are not offered by all plastic surgeons. I encourage all of you to do your own research, ask questions, and if at all possible, consult with plastic surgeons experienced in all types of breast reconstruction before making a final decision.
Dr Chrysopoulo is a breast reconstruction surgeon in San Antonio, TX, specializing in the DIEP flap and other state-of-the-art breast reconstruction procedures. In-network for most US insurance plans. Patients are welcomed from across and outside the US. Please call (800) 692-5565 or email patientadvocate@PRMAplasticsurgery.com to learn more about your breast reconstruction options. Connect with Dr C on Twitter and Facebook.