Staged delayed-implant approach reported for select mastectomy patients

A single-institution review of 19 patients (32 breasts) evaluated the SAFE-DTI protocol, in which permanent implants are placed one to three weeks after mastectomy rather than immediately or via two-stage tissue expansion. The study reported an overall complication rate of 18.8%, including infection, hematoma, and partial nipple-areolar necrosis, with 25% of breasts undergoing revision (mainly fat grafting) within six months. The authors state SAFE-DTI may help address flap perfusion concerns, pathology uncertainty, and scheduling logistics that otherwise complicate immediate direct-to-implant reconstruction.

Most relevant for: Patients undergoing nipple-sparing mastectomy who are candidates for implant-based breast reconstruction but have elevated flap necrosis risk, pending pathology results, or scheduling constraints between oncologic and reconstructive surgery.

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