Case #1201
Direct-to-Implant Reconstruction
43-year-old female with concerning breast findings as well as a strong family history of malignant breast cancer. She elected to undergo prophylactic nipple-sparing mastectomy and Dr. Azadgoli performed direct-to-implant reconstruction with 445cc moderate profile implants place
43-year-old female with concerning breast findings as well as a strong family history of malignant breast cancer. She elected to undergo prophylactic nipple-sparing mastectomy and Dr. Azadgoli performed direct-to-implant reconstruction with 445cc moderate profile implants placed above the muscle.
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Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Nicotine in any form — cigarettes, vapes, patches, gum — paused six weeks before and six weeks after surgery. Nicotine narrows blood vessels and slows wound healing.
- Arrange button-front or zip-front tops for the first three weeks — overhead reaching is restricted. A drain holder or apron is provided.
- Day-of transport and an overnight companion (24 hours minimum) are required for discharge.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Rest, hydration, and short ambulation. Most patients are off prescription pain medication by day 4.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Return to most low-impact activity. Scar massage, compression, and skincare protocols pick up.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
Shape is 80–90 percent of final. Scars are still pink and will continue to lighten through month 12.
Continued care
Recommended aftercare, skincare, and MedSpa services for Direct-to-Implant Reconstruction.
- Compression bra continuously for 6 weeks
- Drain care taught before discharge; removed when output is low (typically 1–2 weeks)
- Sleep elevated on your back for 2 weeks
- No lifting above 10 lb for the first 3 weeks
- Follow-up imaging coordinated with the oncology team
- Medical-grade silicone sheeting on the mastectomy incision
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ on incisions for 12 months
- Priority lymphatic drainage starting week 1
- LED light therapy weekly for the first 8 weeks
- Fractional laser for scar refinement after 3 months
