Hi. Thank you for your well wishes. The plastic surgeon did not think I was a good candidate for one procedure. I was originally upset but he explained why and the more I thought about it I felt so overwhelmed making the decision of what I wanted anyway (silicone, saline or DIEP). I felt a sense of relief not having to make that decision yet. The ps said since I am larger chested that does not make me a good candidate for direct implant. Also in February I had a bilateral lumpectomy with reconstruction and he felt putting a heavy implant at the time of the mastectomy would jeopardize the blood supply to the breast. I spoke to many woman who have been through this and was surprised to find that several have reconstruction the same way. It’s called immediate reconstruction but not direct.