Single surgery mastectomy reconstruction

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Pre-pec mastectomy reconstruction is completed in one surgery, which means less downtime, a lower risk of infection, a quicker return to normal form and function and a cost saving. (Photography by benjamin Margalit/Margalit Studio)

By Mary Malik

Breast cancer diagnosis comes with many questions, fears and unknowns. Decisions need to be made quickly, and you often have very little information. The first question for many women is, “Where do I begin?”

“Because my mother had breast cancer, I had my first mammogram at age 32,” says Mary Kohl. 

“So began years of mammograms, ultrasounds and MRIs that led to a breast cancer diagnosis in February of 2017. Doctors agreed that a bilateral mastectomy was the best course of treatment. I dove into research in search of answers and, trust me, there’s a lot of information out there. But my ultimate answer came from a somewhat unlikely source.”

A few days after Mary’s surgical biopsy, her mother saw an article about how a friend of the family, Mentor plastic surgeon Dr. Paul Vanek, was the first Northeast Ohio surgeon to perform a relatively new mastectomy reconstruction surgery called a pre-pec direct implant procedure. She passed the article on to Mary, who at that time had no idea how important it would soon become. 

“I had several negative biopsies in the past, so I wasn’t too worried about this one,” says Mary. 

“When my cancer was confirmed, I dug out that article and read it again, now from a very different perspective. With my head spinning from the news, my husband and I went to church. Sitting right in front of us that day was our friend—Dr. Vanek. You know what’s better than an internet search? A caring, accomplished surgeon taking the time on a Sunday morning to calm your fears and answer all of your questions.”

Two months later, Dr. Vanek performed a bilateral pre-pec mastectomy with reconstruction on Mary. 


“For Mary, and for all women facing a mastectomy, the decision-making process begins with having all of the information needed,” says Dr. Vanek.

“Being board certified in both general and plastic surgery, I am fully qualified to discuss all available options with my patients. With both certifications, I can uniquely perform all aspects of this new procedure in one surgery, which means less downtime, a lower risk of infection, a quicker return to normalcy and a cost savings. Perhaps most importantly, a woman starts her surgical procedures and wakes up fully intact.”

During the pre-pec mastectomy reconstruction procedure, the breast tissue is removed from underneath the skin and nipple. The full breast skin envelope and nipple are left intact. Reconstruction is completed immediately following, with an implant or the patient’s natural tissue placed above the pectoral muscle, resulting in less pain and discomfort. 

“The pre-pec procedure is a single-stage, oncoplastic surgery,” says Dr. Vanek. 

“Oncoplastic surgery combines the latest plastic surgery techniques with breast surgical oncology to reshape the breast that has been distorted due to a lumpectomy or mastectomy, and restore it to its natural appearance. The pre-pec technique also eliminates the lengthier process of an expansion, which was the traditional reconstruction procedure. Patients can now return home the same day, if that’s their desire, and not face additional surgeries.”

As a teacher, Mary was thirsty for knowledge throughout her consultations and treatment. She worked closely with not only Dr. Vanek, but also his entire staff to decide what was right for her and to become informed about the procedure and recovery. 


“I’ve known Dr. Vanek for over 20 years. Through my own experience and those of friends, I know he is exceptional at his craft,” says Mary. 

“But what also impressed me was his commitment to caring for his patients. And that commitment extends to his staff. Every person I came in contact with demonstrated a dedication to putting patients first.”

Dr. Vanek knows that patients have so many decisions to make throughout a breast cancer diagnosis and subsequent treatments, including where to be treated. Some patients may consider a downtown hospital, but instead decide on a surgeon closer to home. 

“We have such a nurturing and supportive system between my office staff and the team at TriPoint Medical Center,” says Dr. Vanek. 

“It’s a very boutique-style practice for all procedures, but we especially offer a concierge approach to managing breast cancer treatment. I am deeply committed to research and offering the latest procedures that allow my patients to get through this emotional process in an easier, faster and more dignified manner. The pre-pec procedure offers all of that.”

Mary had several reasons for choosing the bilateral pre-pec procedure, but one primary reason for choosing Dr. Vanek—trust. 

“I am now cancer free and I feel and look like myself again,” says Mary.

“I’m back to all of my activities and the job that I love, teaching my second graders. I continue to see Dr. Vanek and find comfort in knowing he is carefully watching over my continued healing. I trusted him with my life, and now I’m looking forward to my future.”

Paul Vanek, MD, F.A.C.S., of Vanek Plastic Surgery, is located at 9485 Mentor Ave., Suite 100, in Mentor. Call 440-205-5750 for more information or visit the website at MentorPlasticSurgery.com.