**6. Delayed reconstruction**

A delayed BR is breast restoration performed at a later date as an independent separate procedure by the plastic surgeon. The patient initially undergoes the oncologic procedure with a mastectomy or breast conserving therapy. Subsequently, the patient pursues Breast reconstruction based on a collaborative approach with the plastic surgeon. This reconstructive option is ideal if there is no availability of plastic surgeon at the facility or if negative margins could not be achieved during the oncologic procedure. Once the patient is cleared from an oncologic standpoint, the BR can be pursued at a later date. Advantages include allowing time to identify a board certified plastic surgeon who will perform the reconstruction at a nearby facility as well as appropriate allotted time for oncologic treatment in terms of achieving final negative margins. The disadvantage of this approach is that by waiting, the patient endures the negative psychologic implications of not having a breast or having a deformed breast until the reconstruction is performed. In addition, with delayed reconstruction there is scarring and fibrosis that forms as part of the healing process that may impact the type of reconstruction that can be performed at a later date [27, 28].
