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Direct-to-Implant Breast Reconstruction

What is Direct-to-Implant Reconstruction?

For women seeking a more streamlined reconstruction process after mastectomy, direct-to-implant breast reconstruction offers an immediate solution, placing a permanent implant at the same time as the mastectomy, avoiding the need for a tissue expander. 

This option is typically available to patients who are candidates for immediate reconstruction, often those with early-stage breast cancer or undergoing prophylactic mastectomy with no need for radiation therapy.

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Key Information

  • Single-Step Procedure: The permanent implant is placed immediately after mastectomy—no tissue expander required.
  • Shorter Treatment Timeline: Fewer surgeries and faster overall recovery than staged reconstruction.
  • Best for Select Candidates: Ideal for those not needing radiation and with sufficient skin and tissue after mastectomy.
  • Implant Options Available: Choice of implant types and sizes to match your body and preferences.
  • No Abdominal Surgery Required: Unlike tissue-based flaps, this option doesn't involve microsurgery or donor site recovery.
  • Immediate Aesthetic Result: Patients wake up with breast volume already restored.
  • May Be a Bridge to Natural Tissue Later: In some cases, implants are used temporarily before converting to a flap reconstruction.
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What to Expect During Surgery

Before surgery, you'll meet with your surgical team to review your personalized plan and ask any last-minute questions. Once you're in the operating room, you'll receive general anesthesia to ensure you're fully asleep and comfortable throughout the procedure. 

If you're having a mastectomy at the same time, your breast surgeon will begin by carefully removing the breast tissue while preserving as much skin—and sometimes the nipple—as possible.

Immediately following the mastectomy, your PRMA plastic surgeon will place the permanent breast implant beneath the chest muscle or just under the skin, depending on your treatment plan. A surgical mesh may also support the implant and help define the breast shape. The surgeon then closes the incisions, using great care with symmetry and aesthetics.

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Before & After

See real results from women who’ve trusted PRMA with their reconstruction journey.
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Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
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Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
Before img-1
Before img-1
Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
Before img-1
Before img-1
Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
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Recovery Timeline

  • Week 1:
    You can expect soreness, tightness, and limited arm mobility during the first week. You’ll have surgical drains in place and will need help with daily activities. Pain is manageable with prescribed medications, and rest is key.
  • Week 2:
    Drains are often removed around this time. Swelling begins to decrease, and gentle movement becomes easier. Most patients can resume light activities.
  • Week 3-4:
    By the third and fourth week, you’ll continue regaining range of motion and energy. Many return to non-strenuous work and daily routines, though patients should still avoid lifting and vigorous activity.
  • Week 5-6:
    Most physical restrictions are lifted. You may feel close to “normal,” but internal healing continues. Final implant positioning and cosmetic results will gradually settle over the next few months.
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The Nation’s Destination for
Sensation Restoration

PRMA has transformed breast reconstruction with their revolutionary TruSense® procedure, a proprietary technique that restores breast sensation in qualified patients—giving back not just form, but feeling.
About TruSense®

Am I a Candidate for Direct-to-Implant Breast Reconstruction?

Not every woman will be an ideal candidate for direct-to-implant breast reconstruction. Like all breast reconstruction options, this approach depends on several factors, such as your medical history, cancer treatment plan, and body characteristics. 

You may be a strong candidate for direct-to-implant reconstruction if:

  • You are having a mastectomy without needing radiation afterward
  • You have enough healthy skin and soft tissue to support the implant
  • You are seeking a shorter overall recovery time
  • You prefer to avoid multiple surgeries or tissue expansion
  • You have not previously had chest radiation or implant-related complications
  • You are in good overall health with no conditions that could impact healing
  • You are comfortable with implant-based reconstruction and understand the long-term considerations
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Find Your Surgeon

PRMA’s board-certified, fellowship-trained microsurgeons perform over 1,000 DIEP flap procedures every year, making us one of the most experienced breast reconstruction centers in the world. Every surgery is performed by two microsurgeons, enhancing safety, precision, and outcomes—with a flap success rate of over 99%. With more than 15,000 reconstructions performed to date, our team delivers world-class expertise you can trust.
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Dr. Minas Chrysopoulo
Championing Advanced Breast Reconstruction Access Nationwide
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Dr. Gary Arishita
Dedicated to Restoring Confidence Through Expert Reconstruction
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Dr. Oscar Ochoa
Board-Certified Plastic Surgeon & Fellow of the American College of Surgeons (FACS)
gary-arishita
Dr. Gary Arishita
Dedicated to Restoring Confidence Through Expert Reconstruction
oscar-ochoa
Dr. Oscar Ochoa
Board-Certified Plastic Surgeon & Fellow of the American College of Surgeons (FACS)

Will Insurance Cover Direct-to-Implant Breast Reconstruction?

In most cases, insurance will cover a direct-to-implant breast reconstruction. Under the Women’s Health and Cancer Rights Act (WHCRA), all group health plans and insurers that cover mastectomy are also required to cover breast reconstruction.

At PRMA, our team works closely with patients and insurance providers to verify coverage and maximize benefits. 

For more information, visit [Insurance FAQs] in the patient resource center. 

Preparing for Surgery

Preparing for Surgery

Many of our patients travel in from all parts of the country for breast cancer surgery and reconstruction. To help you prepare, our team will walk you through every step, from pre-op planning to travel arrangements, to ensure a smooth and supported experience.

Learn more about:
Preparing for Surgery
Travel Accomodations

Frequently Asked Questions

Will my reconstructed breast look and feel natural with an implant?
Implants can restore breast volume and shape, but they don’t feel like natural tissue and won’t restore sensation. Fortunately, PRMA offers TruSense® for patients seeking a more natural feel and sensory restoration.
Can I switch to natural tissue reconstruction later if I choose implants now?
Yes. Many patients initially choose implants—whether for timing, recovery, or personal reasons—and later opt to convert to a flap procedure for a more natural, long-term result.
How do I decide between implant-based and natural tissue reconstruction?
The best choice depends on your anatomy, cancer treatment plan, lifestyle, and long-term preferences. Implants typically involve a quicker recovery, while natural tissue (like the DIEP flap) offers a more permanent, sensation-restoring solution.
Is nipple preservation possible with direct-to-implant surgery?
In some cases, yes. If you’re a candidate for a nipple-sparing mastectomy, the natural nipple can be preserved during surgery. This decision depends on tumor location, breast size, and other health factors.

Start Your Personalized Breast Reconstruction Plan Today

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