Innovations in Breast Reconstruction: Understanding Direct-to-Implant Technology

Authored By Cassileth Plastic Surgery

Woman holding a pink ribbon over her chest

Breast reconstruction after mastectomy is a crucial step in the journey toward physical and emotional recovery for many women. Traditionally, the process involved a two-stage approach: first, tissue expanders were placed, followed by implants in a separate procedure. However, advancements in medical technology have paved the way for a game-changing alternative known as direct-to-implant (DTI) reconstruction.

DTI reconstruction was pioneered by Dr. Lisa Cassileth, and involves the immediate placement of implants during mastectomy, eliminating the need for a second surgical procedure with tissue expanders. This approach not only streamlines the reconstruction process but also offers numerous advantages over traditional two-stage reconstruction, including lowering the risk associated with traditional reconstruction with tissue expansion1.

In addition to the enhanced safety profile, one of the primary benefits of DTI reconstruction is its efficiency. By bypassing the intermediate step of tissue expansion, patients can achieve their desired breast size and shape in a single surgery, reducing overall treatment time and minimizing disruptions to their daily lives. This streamlined approach is particularly advantageous for individuals with busy schedules or those seeking to expedite their recovery process.

Moreover, DTI reconstruction eliminates the discomfort and inconvenience associated with tissue expansion. Patients undergoing traditional two-stage reconstruction often experience multiple visits to the doctor for expansion sessions, which can be physically taxing and emotionally draining. DTI circumvents these challenges, allowing for a smoother and more comfortable recovery experience.

Beyond practical considerations, DTI reconstruction also yields excellent aesthetic outcomes. Studies have shown that patients who undergo DTI procedures report equivalent levels of satisfaction with the appearance of their reconstructed breasts.2 Furthermore, assessments by independent observers corroborate these findings, highlighting the effectiveness of DTI technology in achieving natural-looking results.

Despite its undeniable benefits, DTI reconstruction may not be suitable for all patients.3 Factors such as breast size, tissue quality, and the extent of mastectomy may influence the feasibility of this approach. As with any medical procedure, thorough consultation with a qualified breast surgeon and plastic surgeon is essential to determine the most appropriate course of action based on individual circumstances.

Direct-to-implant reconstruction represents a significant advancement in breast reconstruction, offering patients a streamlined, efficient, and aesthetically pleasing alternative to traditional two-stage procedures. By harnessing innovative technology and evidence-based practices, DTI reconstruction has transformed how plastic surgeons approach post-mastectomy care, empowering patients to reclaim their confidence and quality of life.

Learn More About DTI Breast Reconstruction

If you’re ready to explore the transformative possibilities of direct-to-implant (DTI) breast reconstruction, contact Cassileth Plastic Surgery and the renowned team at Bedford Breast Center in Beverly Hills. With a reputation for excellence in single-stage reconstruction, our expertise and commitment to comprehensive breast healthcare has drawn patients from around the globe. At Bedford Breast Center, cutting-edge technology meets compassionate care, offering patients access to state-of-the-art treatments such as genetic testing, mammography, minimal-incision lumpectomy, and nipple-sparing mastectomy. Whether you’re considering breast reconstruction or seeking personalized breast health services, our dedicated team is here to guide you every step of the way.


1 Annals of Plastic Surgery. One-stage immediate breast reconstruction with implants: a new option for immediate reconstruction. Available: https://pubmed.ncbi.nlm.nih.gov/21734545/. Accessed April 10, 2024.

2 PRS Global Open. Abstract: Direct-to-Implant versus Two-Staged Expander-Implant Reconstruction: Comparision of Risks and Patient-Report Outcomes from A Prospective, Multi-Center Study. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147234/. Accessed April 10, 2024.

3 Gland Surgery. Direct-to-implant breast reconstruction. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4115696/. Accessed April 10, 2024.

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