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Direct to Implant ("One Step") Mastectomy Breast Reconstruction Reduces Number of Surgeries and Time to Final Cosmetic Results
Date:5/23/2013

d Dr. Salzberg. "We typically perform the entire direct to implant procedure in three hours, which is shorter than most other mastectomy and breast reconstruction surgeries and lessens time spent under anesthesia." He added that while some patients will require or opt for a follow-up revision procedure, most won't need further surgery after the initial procedure.

The traditional mastectomy and breast reconstruction procedure requires tissue expanders placed in the breast immediately after breast tissue removal. The expanders are filled with saline over three to six months to stretch the skin and muscle, and permanent implants are placed during a second surgery.

Direct to implant surgery allows a woman to wake from surgery with reconstructed breasts and no waiting time to completion, said Dr. Salzberg. He stressed, however, that the success of a direct to implant procedure requires appropriate patient selection and a comprehensive pre-surgery consultation to confirm that this surgical option is best for the individual woman and to review the risks and benefits.

"An ideal candidate for direct to implant, or one step, breast reconstruction has healthy breast skin that can stretch for the implant and doesn't have excessive sagging, known as ptosis," Dr. Salzberg said. "Also, for a very large breasted woman choosing prophylactic mastectomy, particularly if she wants to spare her nipples, we may first perform a breast reduction followed by a separate surgery for the mastectomy and direct to implant reconstruction."

Dr. Salzberg published his most recent peer-reviewed study on direct to implant mastectomy and breast reconstruction in the November 2012 issue of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. It included women who had mastectomy and breast reconstruction for breast cancer or prophylactically (preventively) because of high genetic risk such as a BRCA mutation or strong family his
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SOURCE New York Group for Plastic Surgery
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