Immediate breast reconstruction takes place at the time of the mastectomy. Usually the mastectomy can be performed in a "skin sparing" fashion, another words the skin of the breast is preserved, and only the underlying breast tissue needs to be resected with the tumor. The nipple is also usually resected because the ducts where the cancer cells originate exit at the nipple. In this type of breast reconstruction the volume of the breast as well as a small skin patch need to be restored.
In cases where there is a high likelihood that after the mastectomy the cancer treatment will include radiation, the reconstruction is usually performed at a later date,. This is called delayed reconstruction, and the reasoning for this approach is that the flap, or the tissue used for reconstruction, can be adversely and unpredictably affected by the radiation. In this type of breast reconstruction, entire breast skin as well as the breast volume need to be restored.