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What is direct-to-implant reconstruction?

Direct-to-implant breast reconstruction, also known as single stage or one step reconstruction, is a combination of mastectomy and breast reconstruction performed during the same operation. The implant is placed either above or below the pec muscles according to your body type, oncologic treatment plan, and the surgeon’s preference. Dr. Zampell performs the majority of breast reconstructions in the pre-pectoral plane, preserving the natural configuration of the pectoralis muscle. 

While this is not the case for every patient, she will discuss the best options for you, taking into consideration your activity level, body habitus, aesthetic goals and oncologic treatment plan. Most direct-to-implant procedures will make use of acellular dermal matrix (ADM)—a scaffolding that helps maintain the implant in proper position.

ADM may also be helpful to camouflage any defects created at the time of mastectomy. Dr. Zampell often performs additional fat grafting to provide improved soft tissue thickness covering the implant, leading to a more natural appearance and a lowered risk of rippling. Your candidacy for direct-to-implant depends upon the shape, skin quality, and projection of your natural breast as well as your preferences for reconstruction.

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Who is a good candidate for direct-to-implant reconstruction?

Typically this type of surgery is best for those patients with moderately sized breasts with minimal sagging of the breast and good skin quality. It is also ideal for women who wish to remain the same size or increase their breast size modestly. It is a reasonable option for women who do not wish to undergo autologous reconstruction.

Patients desiring reconstruction in both breasts, who are at a healthy weight for their frame and are realistic in their expectations, are usually ideal for direct-to-implant surgery. Those who do not qualify for the surgery have compromised tissue at the implant site, have undergone radiation previously, have a BMI greater than 30, or are suffering from an autoimmune disease which may be a contraindication for certain types of implants.

What are the benefits of direct-to-implant surgery?

  • Preservation of healthy breast tissue
  • Psychological benefit of undergoing all the work at once
  • Allows the patient to leave their mastectomy with fully-formed cleavage
  • Offers a realistic-looking outcome

What is recovery like after direct-to-implant surgery?

It is normal to feel sore, fatigued, tight and tender after your direct-to-implant breast reconstruction surgery. You may also experience tingling and numbness throughout your chest and arms. 

Within six weeks you will begin feeling like yourself again and will be able to return to normal activity. Dr. Zampell will provide you with a complete aftercare plan, which will give you physical therapy assignments to make sure that you regain your range of motion as soon as possible. Be sure to avoid extreme stress, vigorous activity and heavy lifting for the first four to six weeks.

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Why choose Dr. Zampell for direct-to-implant surgery?

Dr. Zampell has over a decade of expertise in the field of breast reconstruction, having studied with one of the field’s brightest luminaries, Dr. Robert Allen, creator of the autologous flap techniques used widely around the world today. Dr. Zampell has created a highly compassionate practice space where women can feel comfortable expressing their needs and wishes for reconstruction. Each procedure is tailored expressly to their wishes and unique anatomical indications.

Dr. Zampell graduated with honors from Ohio State University College of Medicine, subsequently pursuing her residency in plastic and general surgery at the NYU Medical Center. She then went on to complete a demanding fellowship in the complex field of microsurgery at the University of California Los Angeles, setting her up for an industrious career of meticulous detail and inspired strategy.

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