Save Your Breast

A Kinder, Gentler, More Beautiful Approach to Breast Reconstruction

Direct to Implant Reconstruction with Nipple-Sparing Mastectomy

The direct to implant (DTI) breast reconstruction procedure provides women with a way to wake up from their surgery without ever missing their breasts. This immediate form of breast reconstruction places a breast implant within the breast at the same time the mastectomy is performed in order to create a beautiful, natural-looking appearance of the affected breast or breasts.

What are the benefits of a direct to implant reconstruction?

  • Patients can wake up from their mastectomy with their new breasts.
  • Reconstruction is performed at the same time as your mastectomy, meaning less time spent in surgery or recovering (a single-step approach).
  • There is no need for tissue expanders since a permanent implant is used right away.
  • Direct to implant reconstruction is paired with a nipple-sparing mastectomy that conceals any scarring for very natural-looking outcomes – the nipple and areola are often left untouched.
  • Breast implants are safe and can be personalized based on a woman’s unique goals and body shape/size.

Is a direct to implant reconstruction right for me?

Dr. Savalia will speak with you and your breast cancer surgeon to determine the best approach for your reconstruction. This direct to implant approach may be a good option if a sufficient amount of breast skin can be maintained during your mastectomy procedure. There will need to be enough remaining skin to accommodate the new breast implant. A nipple-sparing technique is also possible during your mastectomy to maintain a more natural appearance of the breasts after surgery.

In many cases, it comes down to personal preference whether a woman would rather have reconstruction with a flap or implant technique. Implant reconstruction is a popular and safe choice for women who prefer a simpler solution with a wide array of options in terms of final breast size. Because implants don’t last forever, there may be a need to undergo replacement surgery in the future.

Compared to flap surgery techniques, implant-based reconstruction may require fewer surgical operations, and it has a shorter recovery period because tissue is not being taken from other areas of the body to form the new breast. If you like the idea of an implant-based reconstruction, I am happy to consult with you more about this option.



How is a direct to implant breast reconstruction performed?

The direct to implant breast reconstruction will be performed immediately at the time of the nipple-sparing mastectomy. Once the necessary tissue is removed, Dr. Savalia will carefully place the breast implant behind the pectoral muscle and secure it in place. Incisions will then be closed with the skin and nipple at a natural position in balance with the opposite breast.

This entire surgery typically takes about 3-4 hours, including the mastectomy. Most patients are able to return home the day after their surgery.

Will anything need to be done to the other breast?

In cases where reconstruction will be needed in only one breast, many women choose to have an implant and/or perform a breast lift procedure on the breast not affected by cancer in order to improve symmetry between their breasts. This is often performed at the same time as the mastectomy.

What can be expected following direct to implant breast reconstruction?

One of the most appreciated advantages of this reconstruction approach is that it provides women with immediate benefits in a single, one-step surgery. Since the final implant is placed immediately after the mastectomy, the envelope of breast skin never has a chance to contract and shrink, as it sometimes does with a tissue expander method. By performing the reconstruction at the same time as the mastectomy, results can be seen immediately and without additional staged procedures as is necessary with a delayed approach. In some cases, women may decide to undergo secondary surgery in order to refine the symmetry, size, or shape of the breasts once they are fully healed.

Your nipple will also be spared with this procedure, so no further nipple reconstruction or tattooing will be necessary. It will take some time for the breast implants to fully settle into place; however, you will experience immediate benefits and a natural breast shape as soon as you awake from surgery.

Get in Touch with the Save Your Breast Team

If you have questions about breast reconstruction, my staff and I are happy to help. By working with a team of Southern California's most experienced breast reconstruction surgeons, radiologists, and nurses, we are able to provide women with the best possible options for one of the most life-changing and rewarding surgeries. Please contact us online or call (949) 759-0980 for more information.

Dr. Nirav Savalia


Dr. Savalia is known for the most innovative, advanced breast reconstruction techniques. He is a board certified plastic surgeon and artist who creates the most natural, elegant, personalized aesthetic results. He is as renown for his care and compassion as he is for extraordinary outcomes. This is why he was named one of Orange County’s Physicians of Excellence by his peers.

A Team Approach for the Best Breast Care Possible

Dr. Savalia’s Breast Health Center team includes the finest oncologists, radiation specialists, geneticists, and nurse navigators. Being cared for by an established team is a great advantage for patients.

"I prefer a light-handed approach that leaves my patients looking visibly rejuvenated, not surgically enhanced."

Meet doctor Nirav Savalia

What Dr. Savalia's Patients Are Saying


Dr. Savalia is a very gifted surgeon and has true artistic ability. I would HIGHLY recommend Dr. Savalia for any type of plastic surgery. He truly exceeded my expectations. I feel very fortunate to have worked with him and his team and if I ever have any need for a plastic surgeon in the future he will be my first choice.

- RIMA, AGE 55

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