Direct-to-Implant

One Step Breast Reconstruction

Direct to Implant Breast reconstruction is a procedure that is performed by plastic surgeons to reconstruct the breast(s) and remake the patient’s sense of self-image following difficult breast cancer treatment. Women who have a mastectomy or lumpectomy as part of their cancer treatment often consider rebuilding their breasts so they can feel whole again. While this treatment is usually performed in a separate surgery from the mastectomy, it may also be performed at the same time. It all depends on the needs of the patient and the recommendations of the surgeon. Our surgeons at New Jersey Breast Reconstruction Center offer all options to suit the needs and preferences of every patient

Breast Reconstruction Options

Plastic surgeons have a variety of implant breast reconstruction options that they can use:

1. Autologous Tissue Flap Reconstruction

This technique is different from implant-based breast reconstruction in that plastic surgeons use flaps of donor tissue from other parts of the patient’s body instead of an artificial implant. The advantage of this method is that the reconstructed breast is created from the patient’s own tissue. Potential disadvantages of flap breast reconstruction are that it takes longer recovery and there may be some disability in the donor area (e.g. the abdomen).

2. Implant Breast Reconstructions

Implant breast reconstruction is the most common approach to restore breast shape and volume after mastectomy for breast cancer risk reduction or treatment. Plastic surgeons have been using breast implants for more than 30 years. Patients often choose implant reconstruction because of its distinct advantages such as a shorter operative time, lack of donor-site morbidity, and faster return to normal activities. Plastic surgeons may use one of two implant reconstruction techniques based on the needs of the patient.

  • Tissue Expander Reconstruction

This is the traditional approach to implant breast reconstruction in New Jersey. Plastic surgeons use a two-stage process that requires two different procedures to complete the treatment. During the mastectomy, a temporary saline implant device known as a tissue expander is inserted under the breast skin. The idea is to create an empty, soft pocket that is gradually filled with the saltwater solution until the desired size and shape is achieved. The breast surgeon then performs the secondary procedure (after about 2-3 months) to remove the temporary expander and replace it with a permanent saline or silicone implant.

  • Direct-to-Implant (One-Step) Reconstruction

This is a single-state reconstruction that comes across as a great alternative to tissue expander reconstruction for women who are eligible. Direct to Implant is a fairly recent technique that has been enabled by advancements in the field of plastic surgery. The permanent implant is inserted at the same time as the mastectomy. Keep in mind though that while this type of implant-based breast reconstruction is a single-stage procedure, an additional cosmetic procedure may be required to improve the size, symmetry, or shape of the breasts.

DIEP Flap New Jersey

Benefits of Direct to Implant Breast Reconstruction

There are many unique benefits for women who choose direct to implant breast reconstruction in New Jersey:
 

  • The mastectomy and breast reconstruction surgeries are combined into one.
  • Avoids tissue expansion and stretching, a process that can be uncomfortable and take up to 6 months.
  • Breasts are reconstructed right after the mastectomy, which may help lessen emotional stress and maintain a positive body image.
  • Postoperative chemotherapy and radiation therapy usually do not need to be delayed.

IMPLANT

Ideal Candidates for Direct to Implant Reconstruction

Breast reconstruction is an option for most women who have undergone a mastectomy or lumpectomy. However, the approach used will vary from one patient to the other. You may be an ideal candidate for Direct to Implant breast reconstruction if:

  • You have sufficient, healthy breast skin remaining after the mastectomy
  • You do not wish to undergo flap reconstruction
  • You do not require breast radiation therapy
  • You do not have multiple or advanced comorbidities that increase your risk of complications
  • You have a small to moderate breast size and desire a similar size after reconstruction

During your initial consultation visit at New Jersey Breast Reconstruction Center, our plastic surgeons will listen to you and help you determine whether direct to implant technique is for you. It is not uncommon for the surgeon attending to you to recommend a different technique. For instance, women who have enough stores of excess tissue in other areas of the body may benefit from a flap breast reconstruction. Similarly, those who desire to have a significant breast size after reconstruction may need to undergo two-stage implant-based breast reconstruction procedures.

Surgical Techniques

Our surgeons may use one of two different surgical techniques when performing Direct to Implant reconstructive surgery.

 

  • Prepectoral Breast Reconstruction

Over the decades, implants were consistently placed under the pectoralis muscle (chest muscle). This newer technique however allows surgeons to place breast implants over the muscle for patients who have good skin laxity.

  • Subpectoral Breast Reconstruction

subpectoral (below the chest muscle) implant placement is still needed in some cases. This position enables plastic surgeons to add extra soft tissue below the reconstructed breast skin.
Our reconstructive surgeons at New Jersey Breast Construction Center should help you choose a technique that is best suited for your body shape and unique requirements. During your consultation visit for breast reconstruction with implants, our office will help you choose the right implant size, profile, and shape.

Direct to Implant Procedure

Direct to implant reconstructive procedures are performed at the same time as the mastectomy. The breast or general surgeon operating on you will remove breast tissue in a way that preserves your breast skin. The reconstruction part of the procedure will then start so that the plastic surgeon can create a new breast mound to replace the lost tissue. A strip of special skin tissue known as Acellular Dermal Matrix (ADM) is typically used to serve as an extension of the chest muscle. ADM is a donor tissue that contains no human cells or DNA. However, it is incorporated into your tissues and acquires your blood vessels and DNA within 6 weeks. Usage of ADM is important because it helps prevent rejection of the implants. Drains may be placed to help drain excess fluids from the treatment area. Once the reconstruction procedure is completed to achieve the desired natural breast shape, the surgeon will close the incisions using dissolvable sutures. Patients awaken from breast reconstruction surgery with a well-defined breast shape. If need be, cosmetic surgeons can perform a revision procedure to improve breast shape or symmetry.

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Nipple Reconstruction

 

Some women may be able to have a nipple-sparing mastectomy. This means that the nipple-areola complex is preserved during the mastectomy in order to result in natural-looking breasts. If this option is not available, nipple reconstruction may be performed at a later date. This process usually takes place after the breasts are fully healed, which can be months after surgery. Nipple reconstruction is typically completed using a flap of tissue that is arranged to create the appearance of a nipple. Tattooing may also be available for patients who are looking for a nonsurgical option.

Aftercare and Recovery

 

Many women experience soreness, tightness, and tenderness following direct to implant breast reconstruction. Some patients may also experience tingling sensations in the chest and arms. Fatigue is common especially over the first few weeks following this reconstructive surgery. Before you are discharged from the surgical facility, our specialists at New Jersey Breast Reconstruction Center will provide precise aftercare instructions that you should adhere to in order to ensure a smooth recovery. You will be asked to avoid extreme movements and activities, stress, and abrasion at the incision sites. Most women are able to resume light tasks after 6 – 8 weeks. However, it may take up to 4 months before you are able to exercise or engage in other demanding physical activities.

Schedule your Direct to Implant Reconstruction in NJ

 

Direct-to-Implant breast reconstruction can be a physically and emotionally rewarding procedure for women who have lost a breast due to cancer treatment or genetic susceptibility risk reduction. It’s okay to feel sad, anxious, and uncertain when faced with a mastectomy. This is more so true given that your breasts may be a key part of your sexuality, sense of femininity, confidence, self-image, and motherhood for women who have breastfed children. Our surgeons take great satisfaction in performing breast reconstructive surgeries to ensure patients peace of mind and improve their quality of life. We have numerous years of experience performing direct to implant reconstruction along with breast reduction, breast augmentation, breast lift, and similar other procedures. Our team at New Jersey Breast Reconstruction Center treats each patient with utmost compassion, respect, and exceptional care. Get in touch with our office to schedule an initial consultation and learn more about your breast reconstruction options.

More Info

Nipple Reconstruction

 

Some women may be able to have a nipple-sparing mastectomy. This means that the nipple-areola complex is preserved during the mastectomy in order to result in natural-looking breasts. If this option is not available, nipple reconstruction may be performed at a later date. This process usually takes place after the breasts are fully healed, which can be months after surgery. Nipple reconstruction is typically completed using a flap of tissue that is arranged to create the appearance of a nipple. Tattooing may also be available for patients who are looking for a nonsurgical option.

Aftercare and Recovery

 

Many women experience soreness, tightness, and tenderness following direct to implant breast reconstruction. Some patients may also experience tingling sensations in the chest and arms. Fatigue is common especially over the first few weeks following this reconstructive surgery. Before you are discharged from the surgical facility, our specialists at New Jersey Breast Reconstruction Center will provide precise aftercare instructions that you should adhere to in order to ensure a smooth recovery. You will be asked to avoid extreme movements and activities, stress, and abrasion at the incision sites. Most women are able to resume light tasks after 6 – 8 weeks. However, it may take up to 4 months before you are able to exercise or engage in other demanding physical activities.

Schedule your Direct to Implant Reconstruction in NJ

 

Direct-to-Implant breast reconstruction can be a physically and emotionally rewarding procedure for women who have lost a breast due to cancer treatment or genetic susceptibility risk reduction. It’s okay to feel sad, anxious, and uncertain when faced with a mastectomy. This is more so true given that your breasts may be a key part of your sexuality, sense of femininity, confidence, self-image, and motherhood for women who have breastfed children. Our surgeons take great satisfaction in performing breast reconstructive surgeries to ensure patients peace of mind and improve their quality of life. We have numerous years of experience performing direct to implant reconstruction along with breast reduction, breast augmentation, breast lift, and similar other procedures. Our team at New Jersey Breast Reconstruction Center treats each patient with utmost compassion, respect, and exceptional care. Get in touch with our office to schedule an initial consultation and learn more about your breast reconstruction options.

Direct-to-Implant FAQ

FAQ

Will I have visible scars after direct to implant breast reconstruction?

To avoid any unpleasant surprises, it is important that you know what to expect after breast reconstruction surgery. Mastectomy and breast reconstruction, like any other surgical procedures, result in scarring that may take up to one or two years to properly fade. Our surgeons make a point to make this scarring as minimal as possible at the time of the surgery. Furthermore, you will be enrolled in a comprehensive scar management program during and after recovery.

What factors might prohibit reconstructive implant breast surgery?

Reconstructive surgery is a great option for women who are looking to pick up the pieces after a mastectomy. However, plastic surgeons may request that you avoid this treatment if you are too thin, too obese, or have problems with blood circulation. Most surgeons will also ask that you wait at least 2 months after quitting smoking before you can have reconstructive surgery to rebuild the breasts.

Does Insurance Cover Direct-to-Implant Reconstruction?

By law, direct to implant breast reconstruction should be covered by health insurance, whether it is done at the same time as the mastectomy, soon thereafter, or many years later. This coverage includes procedures that might be necessary to enhance the result of the reconstructed breast or enhance symmetry. The Women’s Health and Cancer Rights Act (WHCRA) provides a framework for this coverage.

Will the procedure bring back cancer?

Naturally, some women are worried that having reconstructive surgery might make cancer come back. This is far from the truth. Studies have demonstrated that this surgery does not cause cancer or make it difficult for doctors to diagnose it. If you have more concerns like this, make sure to discuss with one of our cosmetic surgeons during your consultation visit at New Jersey Breast Reconstruction Center.

What anesthetic is used?

Direct to implant breast reconstruction is performed immediately after a mastectomy (as the final step of the procedure). General anesthesia may be used to complete this comprehensive treatment. Women who have undergone direct-to-implant treatment often need to stay at a hospital for a night or two before they are discharged to continue with recovery at home.