DIRECT-TO-IMPLANT

OVERVIEW

Instead of using autologous tissue to reconstruct their breasts right after a mastectomy, some women may be candidates for direct-to-implant breast reconstructive surgery, or a “one-step” reconstruction. Our plastic and reconstructive surgeons, Drs. Torabi offers direct-to-implant reconstruction for patients having a nipple, areola, and/or skin sparing mastectomies, who do not wish to increase their breast size, are nonsmokers, and who will not require radiation therapy after the procedure. During a private consultation at our office at Elite Plastic Surgery, we will discuss all of the options available to you even if you are recently diagnosed and just starting to plan out your treatment.

If saline or silicone implants are chosen, then implant shape, size and type of implant will be discussed thoroughly to achieve an aesthetically pleasing, and natural result. Call today and schedule your consultation appointment.

OUR SURGICAL REQUIREMENTS

In the majority of women undergoing this procedure, a two-step reconstructive procedure is performed. However, in selected patients, this procedure can be performed in a single operation at the time of the mastectomy. An implant is used to reconstruct the breast with the support of a regenerative tissue matrix. Even though there have been great improvements to silicone implants, capsular contracture and implant migration remain a real risk after implant reconstruction, and this may necessitate revision surgeries in the future.

Placement

The silicone implant can be positioned on top of the pectoral muscle, or behind it. When the implant is placed behind the muscle, the muscle has to be cut and lifted during the procedure. A pocket for the implant is created between the muscle and the implant. With this type of placement, the recovery can be painful, and consequently have a slightly longer recovery time.

It is important to note that with placement of the implant on top of the muscle, there must be enough tissue in the upper section of the breast so the implant edge is not as visible. However, if the patient has enough tissue, this is not an issue. It also allows for a less painful, faster recovery, and decreases the risk of movement and distortion of the implant.

Incisions

Incision type and location will be decided with your surgeon to achieve optimal cancer operation as well as reconstruction.

IN RECOVERY

Most of our direct-to-implant breast reconstruction patients experience a dull ache for a couple of days following the breast surgery procedure (particularly if the implant has been placed underneath the muscle). Pain relievers are prescribed, if necessary. You will be required to wear a supportive bra day and night. The recovery time for breast surgery is around 2 weeks with some clients experiencing tenderness for up to 4 weeks or more. Strenuous activity should be avoided for a 6-week period with follow-up treatments to check the results of the procedure once any swelling has subsided.

FOLLOW-UP & CONSIDERATIONS

Your plastic surgeon will discuss any specific risks or complications of breast surgery prior to the procedure. General risks with breast surgery are quite low due to the regularity with which the procedure is performed, but patients must be made aware of minor bruising following the surgery along with associated swelling and tenderness. Wound breakdown and infection can be a problem if aftercare and follow up treatments are not adhered to correctly, which could cause abnormal scarring to the area.

Specific, but uncommon problems caused by the breast reconstruction can include: a collection of fluid around the implant, wrinkles or ripples in the skin, changes in sensation in the breast and nipple area, and contraction of the capsule where the implant is placed. Any concerns or continuing discomfort following breast surgery should be addressed with your plastic surgeon or doctor as soon as possible.