Embrace the Change: Incorporating Single-Stage Implant Breast Reconstruction into Your Practice.

Area of Science:

• Plastic Surgery
• Oncology
• Breast Reconstruction

Background:

• Nipple-sparing mastectomy and single-stage implant breast reconstruction have demonstrated safety and low complication rates.
• Despite evidence, some plastic surgeons remain hesitant to adopt newer breast reconstruction techniques.
• This article details a transition to a "one-and-done" breast reconstruction using shaped implants and acellular dermal matrix.

Purpose of the Study:

• To present the senior author's experience with a single-stage, "one-and-done" breast implant reconstruction.
• To highlight the use of shaped implants and fetal bovine acellular dermal matrix in breast reconstruction.
• To discuss clinical pearls for patient and implant selection, and mastectomy incision choices.

Main Methods:

• A literature review was conducted on single-stage implant reconstruction, including indications, outcomes, techniques, and complications.
• The senior author's operative technique for "one-and-done" breast reconstruction is described in detail.
• Patient selection, implant selection, and mastectomy incision choices are discussed as clinical pearls.

Main Results:

• Twenty-seven single-stage implant reconstructions were performed.
• Shaped implants and acellular dermal matrix were utilized in all cases.
• Complications included erythema, skin ischemia, seroma, partial nipple necrosis, skin necrosis, and exposed/infected implants.

Conclusions:

• Breast reconstruction is evolving towards less invasive, single-stage procedures.
• Aesthetic advancements include nipple-sparing mastectomy, acellular dermal matrix, shaped implants, and fat grafting.
• Selected patients benefit from "one-and-done" breast implant reconstruction without increased oncologic risk, offering superior aesthetic outcomes.