Direct-to-implant Breast Reconstruction
in Beverly Hills
Mastectomy & Breast Reconstruction in One Surgery
Why choose The Practice Plastic Surgery for direct-to-implant breast reconstruction?
Whether responding to breast cancer treatment or as a prophylactic procedure, many women who undergo mastectomy seek breast reconstruction to restore their breasts and regain a sense of wholeness after their surgery. Typically, this step is performed later in a separate procedure. But what if mastectomy and breast reconstruction could be performed in the same surgery?
Board-certified plastic surgeon Dr. Lisa Cassileth wanted a better option for women coping with mastectomy and reconstruction. She pioneered the direct-to-implant reconstruction technique to help breast cancer patients restore their physical and emotional health in a single procedure — while also preserving breast sensation. Read on to learn how our highly qualified surgical team can help you put breast cancer behind you with confidence, grace, and power.
Direct-to-Implant Breast Reconstruction at a Glance
- Single surgery: Our surgeons pioneered the art of performing mastectomy and implant reconstruction in one procedure.
- Candidates: Our advanced techniques open the possibility of direct-to-implant reconstruction to a much wider range of patients.
- Safety Protocol: Meticulous surgical and recovery protocols significantly enhance success rates with minimal risk of complications.
- Results: Wake up from your mastectomy with reconstructed breasts and a high rate of preserved breast sensation.
- Dr. Cassileth’s advanced approach allows reconstruction patients to achieve their goals while giving them the best chance of maintaining or restoring breast sensation following the procedure.
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Direct To Implant Before & Afters
Expanding the Standards of Care
What is direct-to-implant breast reconstruction?
Direct-to-implant reconstruction is when breast reconstruction is performed during the same surgery as mastectomy. Traditionally, the vast majority of breast reconstruction patients have reconstructive surgery in stages, requiring at least two surgeries. The traditional approach involves placing tissue expanders to stretch the breast skin in preparation for implants, plus appointments over the course of 2 to 6 months, to gradually increase the size of this expander. Direct-to-implant reconstruction eliminates these steps. Mastectomy and breast reconstruction are completed in one procedure, allowing the patient to wake up from surgery to fully reconstructed breasts.
Heal Beautifully
What are the benefits of direct-to-implant breast reconstruction?
Our direct-to-implant reconstruction method was developed to raise the standard of care for women who have been diagnosed with breast cancer. Too often, women face a long reconstruction journey that yields sub-optimal results and often requires revision surgery. We believe that women deserve better. By performing mastectomy and implant reconstruction in one procedure, we help you achieve full healing for body and mind. Rather than aiming to make you “look normal in clothes,” we focus on crafting results that help you feel beautiful and confident no matter what you are—or aren’t—wearing.
Direct-to-implant reconstruction offers life-changing benefits:
- Single procedure: Mastectomy and reconstruction are performed in a single surgery, reducing overall recovery time so you can complete your recovery journey.
- Beautiful outcomes: Collaboration between your breast surgeon and plastic surgeon provides the most harmonious, aesthetically pleasing result possible.
- Focus on safety: Our rigorous peri-operative protocol ensures optimal safety and comfort throughout your entire surgical procedure.
Versatile Approaches to Meet Your Unique Needs
Am I a candidate for direct-to-implant breast reconstruction?
Many mastectomy patients are told they are not candidates for direct-to-implant reconstruction—that only women with smaller, perky breasts can undergo this procedure. For more than 15 years, our surgeons have performed hundreds of successful direct-to-implant breast reconstruction surgeries, demonstrating the efficacy of this approach.
We work carefully alongside you and the mastectomy surgeon to assess your candidacy and match you with the safest surgical techniques for your unique needs. Our expert team draws on an extensive repertoire of approaches to perform a procedure that yields beautiful results to restore your health and confidence.
A Carefully Orchestrated Collaboration
Who performs the direct-to-implant breast reconstruction procedure?
Direct-to-implant breast reconstruction is a carefully orchestrated collaboration between the oncological breast surgeon and the plastic surgeon performing the reconstruction. We only work with mastectomy surgeons whose track record shows an extremely low incidence of mastectomy flap necrosis (tissue death). Our doctors exclusively work with the surgeons at Bedford Breast Center to deliver comprehensive and cohesive care; this collaborative approach allows us to maintain a mastectomy flap necrosis rate of only 1% while most surgeons have 30% or higher.
Our breast cancer surgeons specialize in nipple-sparing mastectomy and skin-sparing mastectomy. These use a very small incision along the crease under the breast, a sophisticated technique not all surgeons can accomplish. By working with only the best oncological breast surgeons, we deliver a high-quality result that far exceeds the accepted standards of mastectomy and breast reconstruction care.
What is the direct-to-implant breast reconstruction procedure like?
We employ a meticulous protocol from initial consultation through full recovery. Our methods are based on years of surgical experience and empirical research and have a very high success and patient satisfaction rate.
Consultation
The first step of your journey is a consultation with one of our highly skilled reconstruction surgeons. Our compassionate providers spend time listening and learning about your specific needs. Your plastic surgeon will assess your medical history, breast cancer diagnosis, and treatment plan to determine if you are a good candidate for direct-to-implant breast reconstruction. Additionally, our team will walk you through any pre-operative guidelines.
Pre-operative planning: Factors like your anatomy and specific aesthetic goals will determine the best approach for your combined mastectomy and reconstructive surgery. The details of your procedure will be outlined during your pre-operative appointment. At this time, your surgeon will review any preparations for surgery, such as pausing the use of certain medications and all aftercare instructions, ensuring you are well prepared at every stage.
Special Surgical Techniques
We used specially developed techniques to prevent some common problems associated with breast implants in mastectomy patients.
For example, we create an internal bra using acellular dermal matrix (ADM), a type of connective tissue graft. This technique helps to hold the implants in place with minimal risk of shifting downward. It goes beyond the method most surgeons use of simply wrapping the implant in acellular dermal matrix before placing it in the pocket.
We also leave the pectoral muscle intact by placing the implant over the muscle, which promotes a much more comfortable recovery. It also helps to prevent “pec flex,” a type of animation deformity in which the breast shape can shift and look unnatural when the pectoral muscles flex.
Finally, we help to preserve sensation in the breasts by meticulously reconnecting the superficial nerves to the deep nerves. Unlike traditional mastectomy approaches, our technique helps restore sensation as the nerve regrows through the graft during recovery.
Rigorous Recovery Protocol for Optimal Results
Direct-to-Implant Breast Reconstruction Recovery
Our recovery protocol focuses on enhancing comfort and safety at every step. Special perioperative measures include:
- Prevena VAC device placed around the incision site for the first five days of recovery lowers infection risks and enhances oxygenation, expediting healing and reducing pull on the skin for better cosmetic results.
- Exparel nerve-blocking injections administered during surgery block pain for three days after your procedure, helping you be more mobile and recover sooner.
- Concierge nurse staff remains on hand to attend to your daily needs and ensure an optimal recovery.
The total recovery time varies depending on the surgery details and individual healing rates. Discomfort and swelling usually peak during the first week after surgery and improve in the second week. Your surgeon will provide tailored guidelines on when to return to more strenuous activities. Our concierge nurse staff remains constantly available to answer questions, address concerns, and coordinate ongoing communication with your surgeon.
Confidence, Grace, and Power
Direct-to-Implant Breast Reconstruction Results
Direct-to-implant reconstruction provides the transformative opportunity to restore your health and self-confidence in one surgery. Our innovative techniques bypass the need for tissue expanders, streamlining the reconstruction process into a single surgery. With direct-to-implant reconstruction, patients can wake up to beautiful breast contours. With our pioneering techniques, you can embark on your recovery journey with a renewed sense of health, wholeness, and feminine power.
Direct-to-Implant Breast Reconstruction
Frequently Asked Questions
Traditional mastectomy techniques result in numbness in the breast and nipple. Our nerve grafting technique during mastectomy surgery involves meticulously reconnecting severed nerves to skin nerve endings, offering the possibility of restored sensation. Breast sensation typically begins to return as soon as three months post-mastectomy. Sensation may continue to improve over several months to a year as the nerves regrow and reconnect.
For patients who prefer to go flat after mastectomy, we perform aesthetic flat closure to provide a smooth chest appearance without implants. This approach creates a smooth contour without the risk of a concave chest appearance.
Our skilled surgeons also provide SWIM breast reconstruction, a one-stage surgery using the patient's tissue to construct a breast instead of implants. Schedule your consultation to learn more about your options.
