I was referred to The Centre by the on call hand Doctor that reviewed my ER case after I split my thumb open. From setting up my appointment to being taken care of by the staff, it was a pleasant experience. Each member of the team I met was attentive, very forthright with any information I needed & were an absolute pleasure to be around. Dr. Downs has an amazing staff!

Types of Breast Reconstruction
Implant-Based Reconstruction
Direct to Implant Reconstruction:
Single stage approach is most suitable for candidates of nipple sparing, skin sparing mastectomies. A permanent implant, silcone or saline, is inserted immediately following the mastectomy.
Tissue Expander / Implant Reconstruction:
Option 2 would be a two-stage procedure where at the time of the mastectomy a tissue expander is inserted into the pocket under the skin. This device is gradually filled with saline over the course of several weeks to stretch the skin. Once the desired volume is achieved, in a secondary operation, the expander is removed and replaced with a permanent implant.
Oncoplastic Reconstruction or Breast Conservation Reconstruction
Oncoplastic or breast conservation reconstruction is the removal of breast cancer while still leaving an adequate portion of breast tissue behind to make a cosmetically appealing breast.


Flap Reconstruction
Flap reconstruction uses tissue from other parts of the body to recreate the breast. Options include:
- TRAM Flap: Skin, Fat and Muscle are taken from the abdomen to create a natural looking and feeling breast.
- Latissimus Dorsi Flap: An ellipse of muscle and tissue is taken from the back and repositioned to the chest, often combined with an implant.

It has been officially 5 week since my tummy tuck and breast lift. After losing 150lbs I knew I needed this done but never thought it would be possible. After meeting with Dr. Downs and his team my dreams started to seem like reality. Five weeks ago we completed 1 of my 2 suggested surgery’s. My recovery so far has been extremely easy with little to no pain. Dr. Downs has been just the best. He took his time and explained every part of my surgery and what I could expect. It was a pleasant surprise to wake up from surgery and find out he didn’t have to make the vertical incision down my stomach due to all the my weight loss, and lose skin. I’m so happy Dr. Downs is who I decided to go to for this surgery. Can’t wait for him to complete my project.
Dr. Macias is AMAZING!! She is so caring and kind. She listens to her patients and seems to really love her job and cares about her patients. I would highly recommend her. Her staff also has been very wonderful and caring all the time!
From the time I walked in the door to the moment I walked out, I felt respected, seen and heard! The staff are kind and gentle and I will never go anywhere else for the things I need. Dr. Macias is outstanding.
Everyone is so professional, compassionate, and willing to help in anyway.
I would recommend their office to everyone.
I had a great experience here, the staff are so friendly and make you feel comfortable. Dr. Downs is the best, I will definitely be returning.
Everyone here is so kind, helpful, talented and caring.I trust highly in them and will always come to them for all my cosmetic concerns and care!!❤️
Dr. Macias and her staff helped make this very personal decision easy and comfortable. They took the time to listen and answered all my questions. I was very nervous about having breast surgery but after it was done I was so happy with the results. She truly nailed it. I would highly recommend Dr. Macias to anyone considering any cosmetic surgery.
Dr. Downs and The Centre, P.C. staff are wonderful to work with for questions/concerns prior to and after surgery during recovery period. Dr. Downs consults with patient prior to surgery to confirm understanding of what results are important to them.
Additionally, Dr. Downs personally follows up after surgery to ensure that things are going well after discharge which I was extremely impressed by. The office/surgical center provides a more discrete and personalized patient environment with a separate door entrance for the follow-up appointment the day after surgery as well.
I received a rhinoplasty from Dr. Macias and my nose is PERFECT. 😍
I enjoyed my whole experience but here are a few specific highlights that stuck out:
- The staff is kind, informative, and responds quickly.
- I loved the simulation they used to show desired results.
- The staff the day of surgery was fun and helped me with my nerves.
- From the little shopping I did, their prices were the best (sometimes by far!).
The medspa staff are always friendly and welcoming. Kellee has the LIGHTEST touch with an injection needle and always does a great job!
Dr. Macias and her staff helped make this very personal decision easy and comfortable. They took the time to listen and answered all my questions. I was very nervous about having breast surgery but after it was done I was so happy with the results. She truly nailed it. I would highly recommend Dr. Macias to anyone considering any cosmetic surgery.
Frequently Asked Questions
about Breast Reconstruction in Mishawaka, IN
Candidates include individuals who have undergone mastectomy, lumpectomy, or prophylactic mastectomy. Your surgeon will assess your medical history and treatment plan to determine eligibility.
Breast reconstruction is often covered by insurance under the Women’s Health and Cancer Rights Act. Our team can assist you in understanding your coverage and options.
Yes, delayed reconstruction is a viable option for many patients and can be performed months or even years after the initial surgery.
While reconstructed breasts may not feel identical to natural breasts, modern techniques provide highly realistic results in appearance and touch.











