Balancing Risk and Reconstruction: A Comprehensive Review of Complications in Delayed Breast Reconstruction

Breast cancer accounts for nearly one in four cancer diagnoses amongst women, with 36–50% of patients electing to undergo post-mastectomy breast reconstruction. Though immediate reconstruction has risen in popularity due to higher patient satisfaction scores, factors such as individual patient anatomy, patient preference, and adjuvant oncologic treatments may preclude this option for some patients. In such circumstances, a delayed approach to reconstruction offers a promising alternative, often offering comparable aesthetic results with lower rates of major complications. Autologous, implant-based, and hybrid reconstructive techniques may all be applied in a delayed setting at a time point clinically distinct from oncologic resection, with each technique carrying unique advantages and risks that must be evaluated in the context of patient-specific factors. By providing an overview of common complications associated with various delayed breast reconstruction modalities, this review seeks to synthesize the current approaches to prevention, management, and treatment of reconstructive obstacles and outcomes to foster shared decision-making, individualized surgical planning, and optimal reconstructive results.