Dr. Lisa Cassileth: Inventor of Direct-to-Implant Reconstruction

At Bedford Breast Center, innovation has always been part of our DNA. One of the most significant contributions to breast cancer surgery in the last two decades came from our founder, Dr. Lisa Cassileth, MD, FACS — the inventor of Direct-to-Implant (DTI) breast reconstruction.

Before DTI, women undergoing mastectomy typically needed a staged approach: first, a tissue expander was placed, then later swapped for a permanent implant in a second operation. Dr. Cassileth developed a way to skip that process, placing the final implant at the time of mastectomy. This means fewer surgeries, faster recovery, and a more natural outcome — all without sacrificing safety.

Today, Direct-to-Implant has become a gold standard option worldwide. But at Bedford, where it was first pioneered, it remains one of the most refined and safest procedures — thanks to our unique structure.

The Bedford + The Practice Difference

What makes DTI at Bedford truly distinct is the integration between Bedford Breast Center and The Practice Healthcare.

At most hospitals, your breast surgeon and your plastic surgeon are on separate teams — often with different schedules, philosophies, and workflows. That separation can lead to longer operations, less predictable outcomes, or the need for staged reconstruction.

At Bedford + The Practice, your breast surgeon (who performs the mastectomy) and your plastic surgeon (who performs the reconstruction) work together as one coordinated team, in one center, during one surgery.

This partnership ensures:

• Perfect timing — the reconstruction begins the moment the mastectomy is complete.
• Unified surgical strategy — breast and plastic surgeons plan the procedure together, minimizing risks like flap necrosis.
• Streamlined care — patients never bounce between providers; every step is coordinated under one roof.
• Consistent safety protocols — all surgeons follow the same advanced safety checklist, refined by Dr. Cassileth herself.

As Dr. Cassileth explains: “DTI only works when the breast and plastic surgeons are in complete sync. That’s why we built Bedford and The Practice side by side — so we could deliver this surgery the way it was meant to be done.”

Why DTI Is a Game-Changer for Patients

• One Surgery Instead of Two: No expanders, no second operation.
• Faster Recovery: Patients heal faster — both physically and emotionally.
• Natural Results: Collaboration between breast and plastic surgeons achieves symmetry and softness right away.
• Reduced Emotional Burden: Reconstruction is complete at the same time as cancer surgery, reducing uncertainty and stress.

How We Keep DTI Safe at Bedford + The Practice

Safety is what sets our DTI program apart. Here’s how our combined team protects every patient:

1. Precise Surgical Planning – Breast and plastic surgeons plan together, reducing complications like flap necrosis (national average up to 30%; our rate under 5%).
2. Real-Time Blood Flow Checks – SPY imaging confirms safe oxygen levels before reconstruction proceeds.
3. Thoughtful Implant Selection – Implants are chosen to fit the patient’s anatomy, prioritizing safety and long-term results.
4. No-Touch Technique – Implants placed using sterile Keller Funnel method, reducing contamination risks.
5. Advanced Healing Supports – Biologics (like PRP or exosomes), specialized dressings, and on-site hyperbaric therapy accelerate recovery and protect results.

Our team may also use advanced healing therapies to support blood flow and tissue repair. Every plan is customized so recovery is as safe and smooth as possible.

The Birthplace and the Benchmark

Direct-to-Implant reconstruction was invented here — and perfected here.

With Bedford Breast Center and The Practice Healthcare working seamlessly together, patients benefit from innovation, collaboration, and an unparalleled commitment to safety.

One roof. One team. One surgery. That’s the Bedford + The Practice difference.

Final Word
 Direct-to-Implant reconstruction represents the very best of what breast surgery can be: innovative, patient-centered, and safe. At Bedford Breast Center and The Practice Healthcare, we are proud not only to have invented this procedure, but to have built the collaborative model that makes it safer, smoother, and more successful than anywhere else.