Direct to Implant Procedure Now an Option for Women Facing Mastectomy - Ascension Wisconsin

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Direct to Implant Procedure Now an Option for Women Facing Mastectomy

Wheaton Franciscan Medical Group physicians Jodi Brehm, MD and Michael Sweet, MD began a unique partnership several years ago that started with a common vision; both forward thinking surgeons wanting to use the latest and best techniques to help women overcome breast cancer while achieving a cosmetic result that makes them happy.

Breast Reconstruction: Direct to Implant

There have been significant and positive changes in breast cancer treatment in the past ten years but according to Dr. Sweet, a plastic and reconstructive surgeon, none more than the introduction of the direct to implant surgery, a one-step breast reconstruction procedure in which a breast implant is inserted at the time of a mastectomy without the need for a tissue expander and the subsequent expansion process.

“No one wants to have a mastectomy and many women facing this surgery feel overwhelmed," he says. "I want to help them get back to all their activities with complete confidence. Reconstruction can actually be positive; it says they're going to be around for a long time and we want to help them feel and look great."

Mastectomy & Reconstruction

A mastectomy is the surgical removal of breast tissue to treat or prevent breast cancer, performed by a breast or general surgeon. Breast reconstruction, performed by a plastic surgeon, rebuilds the breasts after mastectomy. Breast reconstruction can be done in a separate surgical procedure but it can also be performed at the same time as the mastectomy called direct to implant. Which surgery is right for each patient depends on the recommendations of the surgeons.

Dr. Brehm, breast surgeon explains, “Women who are undergoing mastectomy and reconstruction are doing so either for risk reduction or for treatment of breast cancer. This is a very difficult and personal decision for a woman to make. For women who are undergoing surgery to decrease their risk of breast cancer, a single surgery allows them to get back to their normal lives faster and greatly reduces the risk of cancer. Women with breast cancer are often looking at additional therapy, in addition to surgery, to treat their disease. To not have to undergo a second operation at the end of an emotionally and physically draining period of treatment can relieve an incredible burden for women mentally, physically, and financially as well.”

Drs. Brehm and Sweet have gained considerable experience and knowledge since that first surgery together four years ago. Today, direct to implant surgeries account for more than half the surgeries they perform together and they’re steadily expanding the parameters for who qualifies for this surgery to include more women.

Best Candidates for Direct to Implant Surgery

  • Patients with moderate-to-large breasts who will tolerate smaller breasts after reconstruction
  • Patients undergoing skin, or nipple-sparing mastectomies
  • Non-smokers
  • Women whose breast skin is healthy and able to accommodate the implant
  • Women without diabetes

How is Direct to Implant Surgery Different from Traditional Breast Reconstruction?

During traditional breast reconstruction, the plastic surgeon inserts a tissue expander immediately after the breast tissue is removed. Over the next several months, the tissue expanders are filled with saline to stretch the skin and chest muscle to create a pocket for a permanent implant. Once the breast skin and muscle are fully expanded, a second surgery is performed to exchange the tissue expander for a silicone or saline breast implant.

“With direct to implant breast reconstruction; an implant is inserted immediately following breast tissue removal. By using a special grafting material, I’m able to create a pocket sufficient to place an implant underneath. This procedure allows the patients to bypass the whole expansion process,” explains Dr. Sweet.

Why Choose Direct to Implant Breast Reconstruction?

“Women who are able and decide to have this surgery do so to avoid months of tissue expanding, a second surgery for permanent implants, and to achieve great aesthetic results. The direct to implant breast reconstruction technique is often performed with a nipple-sparing mastectomy when possible, so that a woman can keep her own nipple area for more natural appearing breasts,” says Dr. Brehm.

Advantages of direct to implant surgery:

  • Only one surgery is needed for the mastectomy and breast reconstruction to be complete
  • Avoidance of tissue expanders and the stretching process, which can be uncomfortable and take several months
  • Breast in place right after mastectomy may help lessen emotional stress and preserve a positive body image

Many patients today do their own research and are aware of all types of treatments. Dr. Brehm says it's important for patients to know what’s out there. Dr. Sweet adds, “Every woman’s objectives and anatomy is different, so it really is an individual process but reconstruction is important for many women to feel good again. Dr. Brehm and I walk our patients through all the options available to them. We listen to their wishes and help them accomplish their goals.”

How to Schedule an Appointment

To schedule an appointment with Dr. Jodi Brehm, call 414-256-1920 and Dr. Michael Sweet, 262-687-8677.

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