Direct Implant Reconstruction
In certain cases patients may be candidates for direct implant reconstruction. Post mastectomy reconstruction with a direct to implant, or “one-step” approach, allows for a single-stage reconstruction of the breast in the same operation as the mastectomy. This option is best for patients with good preservation of the breast skin following mastectomy, good skin tone, and moderate sized breasts. A permanent implant is inserted immediately following the mastectomy, forgoing the placement of a tissue expander and subsequent expansion process.
A second stage procedure may still be considered in some cases for minor refinements in contour and symmetry without exchanging the implant. This usually occurs several months after the first primary procedure, allowing time for swelling and healing to occur.
Choosing Your Implant
Together with your surgeon, you will decide which implant best suits your individual needs. There are two general categories for implants: saline-filled, and the new generation of silicone cohesive gel-filled implants (“gummy bear implants”). The advantages of gel implants are that they tend to be softer; with a feel that is more like natural breast tissue. Also, gel implants can have less rippling and visibility as compared to saline implants. Both types of implants come in numerous shapes, sizes, and profiles.
In two to three months, the next stage of surgery will be performed to reconstruct the nipple and areola. If desired, additional contouring procedures, such as fat injections, can be performed to adjust breast shape at this third stage.