Data Shows Efficacy and Aesthetic Benefits of Direct-to-Implant Mastectomy Breast Reconstruction

Study finds "One-Step" procedure helps reduce discomfort, limit total number of surgical procedures and speed time to final cosmetic results

Jan 03, 2013, 09:43 ET from Dr. Salzberg and the New York Group for Plastic Surgery

TARRYTOWN, N.Y., Jan. 3, 2013 /PRNewswire/ -- Direct-to-Implant, or One-Step, breast reconstruction following mastectomy to treat or prevent breast cancer is effective, safe and offers aesthetic benefits when performed on appropriate patients, according to peer-reviewed data published in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons.

The study included women who had mastectomy to treat a diagnosis of breast cancer and others who chose prophylactic (preventive) mastectomy because of high genetic risk such as a BRCA mutation or a strong family history of breast cancer. Recently, celebrities including talk show host Sharon Osbourne and Miss America contestant Allyn Rose of the District of Columbia (D.C.) publicly discussed their breast cancer risk and mastectomy plans to help educate and raise awareness.

"Undergoing mastectomy to treat or prevent breast cancer is an enormous physical and emotional event for a woman. Direct-to-Implant breast reconstruction represents an important step forward in reducing physical discomfort as well as time to final cosmetic results for mastectomy patients," said study author C. Andrew Salzberg, MD, associate professor at NY Medical College and Chief of Plastic Surgery at Westchester Medical Center and St. John's Riverside Hospital at Dobbs Ferry Pavilion, who pioneered the Direct-to-Implant breast reconstruction procedure 11 years ago. 

Traditionally, post-mastectomy breast reconstruction requires tissue expanders to be placed in the breast immediately after the breast tissue is removed. The expanders are filled with saline over three to six months to stretch the skin and muscle in preparation for implants, a process that can be painful for some patients. A second surgery is required to insert the permanent implant.

The Direct-to-Implant, or One-Step, procedure provides an immediate breast reconstruction within one surgery. A permanent implant is placed in the breast immediately following mastectomy. A specially prepared skin tissue, or "acellular dermal matrix," is placed over the implant as a muscle extender, avoiding the need for tissue expanders. The majority of patients will not require a second surgery. Direct-to-Implant reconstruction is often performed with a type of mastectomy that allows a woman to retain her own nipples.

In addition to reducing recovery time, discomfort and the total number of surgical procedures, Dr. Salzberg notes that the convenience of One-Step breast reconstruction offers a woman potential emotional benefits. "Waking from surgery with breast implants already in place can reduce the emotional stress that is often associated with a mastectomy, and help preserve a positive body image," he said.

The peer-reviewed data captures results from 439 procedures that Dr. Salzberg performed over a 10-year period in 439 patients (790 breast reconstructions).  Results indicate consistently low complication rates at an incidence of less then two percent, including implant loss (1.6 percent), skin necrosis requiring reoperation (1.3 percent), infection (1.1 percent), hematoma (0.6 percent), seroma (0.5 percent) and capsular contracture (0.5 percent).

Dr. Salzberg noted that the success of the procedure does require appropriate patient selection and specific intraoperative technique principles.

"As with any surgical procedure, a comprehensive pre-surgery consultation is crucial to review all reconstructive options and the risks and benefits of each," he said.  "An ideal candidate for Direct-to-Implant, or One-Step, reconstruction will have healthy breast skin that can accommodate the implant, without excessive sagging (ptosis).  Also, very obese patients tend to be better served by other reconstructive options that may involve fat or muscle transfer."

Dr. Salzberg's study, Focus on Technique: One-Stage Implant-Based Breast Reconstruction, was published in the Featured Supplement of the November 2012 issue of Plastic and Reconstructive Surgery. The study was also cited as expected to impact the practice of plastic surgery by physician experts at Medscape, a leading educational web resource for physicians and other health professionals. More about Direct-to-Implant breast reconstruction can be found at:

About Dr. Salzberg and the New York Group for Plastic Surgery
C. Andrew Salzberg, MD specializes in breast reconstruction and cosmetic procedures as a principal surgeon with the New York Group for Plastic Surgery (NYGPS). He regularly performs Direct-to-Implant breast reconstruction on women from around the country who are undergoing mastectomy for cancer treatment or prevention. The New York Group for Plastic Surgery is comprised of highly trained plastic surgeons certified by the American Board of Plastic Surgery (ABPS) and recognized for their specialized medical and cosmetic surgical skills and personalized patient care. 

For interviews with Dr. C. Andrew Salzberg and patients who have undergone Direct-to-Implant breast reconstruction, contact:       

Andrea Ziltzer

Tom Murphy


SOURCE Dr. Salzberg and the New York Group for Plastic Surgery