Reconstruction in Los Angeles
Breast Reconstruction After Mastectomy
Breast reconstruction after mastectomy can happen at the same time as your mastectomy or months to years later, with your own tissue or with implants. In Los Angeles, Michael DeLong, MD, a UCLA fellowship-trained microsurgeon, works alongside your breast surgeon and oncologist to plan the timing and approach that fits your treatment.
Medically reviewed by Michael DeLong, MD, Board-certified plastic surgeon (American Board of Plastic Surgery), UCLA microsurgery fellowship. Last updated .
Immediate vs. delayed breast reconstruction after mastectomy
Immediate reconstruction begins during the same operation as the mastectomy; delayed reconstruction is done later, after healing or after other treatments such as radiation.
Immediate reconstruction can preserve more of the breast skin and means waking up with a breast shape already started. Delayed reconstruction may be advised when radiation is likely, when health needs to be optimized first, or simply when you want more time to decide. Some patients have a "delayed-immediate" approach with a temporary tissue expander.
Breast reconstruction after radiation
Radiation makes the skin and tissue tighter and less elastic, which raises the risk of complications with implants; reconstruction with your own tissue is often recommended after radiation.
Flap reconstruction brings in healthy, non-radiated tissue with its own blood supply. Timing is usually several months after radiation is complete so the skin can recover. Learn about DIEP flap reconstruction.
Breast reconstruction years after mastectomy
There is no deadline: you can have breast reconstruction many years after a mastectomy, and insurance protections under WHCRA still apply.
Patients come in years later for many reasons — they weren't offered reconstruction, weren't ready, had an implant reconstruction that no longer feels right, or simply want to feel whole again. Delayed reconstruction is common and well established.
Insurance and the Women's Health and Cancer Rights Act
The federal Women's Health and Cancer Rights Act (WHCRA) of 1998 requires group health plans and insurers that cover mastectomy to also cover breast reconstruction.
Under WHCRA, covered benefits include:
- Reconstruction of the breast on which the mastectomy was performed.
- Surgery and reconstruction of the other breast to produce a symmetrical appearance.
- Prostheses (such as breast forms or implants).
- Treatment of physical complications of mastectomy, including lymphedema.
Your plan's usual deductibles and co-insurance apply, and prior authorization is usually required. Read our full guide on breast reconstruction insurance coverage.
Working with your breast surgeon and oncologist
Reconstruction works best as a team effort: your breast surgeon removes the cancer, your oncologist guides treatment, and your plastic surgeon plans reconstruction around both.
Dr. DeLong communicates with your cancer team about incision placement, whether radiation is expected, and chemotherapy timing so reconstruction fits safely into your care. Bring your pathology and treatment plan to your consultation if you have them.
What to expect at your breast reconstruction consultation in Los Angeles
Your first visit is a conversation about your diagnosis, treatment plan, health history and goals, followed by an examination and a review of the options that fit you.
- Review of your cancer treatment plan and timing.
- Discussion of implant, flap and combined options, including pros and risks of each.
- Examination, and clinical photographs with your consent.
- An outline of stages, recovery and insurance steps.
Compare all options on our page about breast reconstruction in Los Angeles.
Reconstruction results
These are Dr. DeLong's own consented patients after mastectomy.
- Immediate DIEP FlapReconstruction at the time of mastectomy.View before & after
- Delayed DIEP Flap after Mastectomy and RadiationReconstruction after radiation therapy.View before & after
- Immediate PAP FlapThigh-tissue reconstruction at the time of mastectomy.View before & after
Consented patient photos. Individual results vary.
Breast reconstruction after mastectomy FAQs
Will reconstruction delay my cancer treatment?
Reconstruction is planned around your cancer care, not the other way around. Your breast surgeon and oncologist set the treatment timeline, and reconstruction is coordinated so it does not hold up chemotherapy or radiation.
Does reconstruction make it harder to detect a recurrence?
Reconstruction generally does not prevent detection of recurrence. Your oncology team will advise on follow-up exams and imaging after mastectomy and reconstruction.
Can I keep my nipple?
Nipple-sparing mastectomy may be possible depending on tumor location, breast size and shape, and your breast surgeon's assessment. If the nipple is removed, nipple reconstruction or 3D tattooing can be done later.
What if I had a lumpectomy instead of a mastectomy?
Partial reconstruction or reshaping can address dents or asymmetry after lumpectomy and radiation, sometimes with fat grafting or local tissue rearrangement.
Is it okay to decide not to have reconstruction?
Yes. Going flat is a valid choice, and a plastic surgeon can help create a smooth, even chest contour. Coverage protections apply if you change your mind later.
How many surgeries does reconstruction take?
Most reconstructions involve one main surgery plus one or more smaller refinement stages, such as symmetry adjustment, fat grafting or nipple reconstruction. The number depends on the approach and how you heal.
Talk with Dr. DeLong about your options.
Consultations are personal. Options, recovery and outcomes vary by individual.
This page is general information, not medical advice, and does not create a physician–patient relationship. Individual results vary. No specific outcome is guaranteed.