In DTI reconstruction, the implant is put in just after the mastectomy is performed. No tissue expander is used. To hold the implant in place, a sling made out of purified collagen, called acellular dermal matrix (ADM), may be used. The ADM provides a meshlike framework that gives additional support to the implant.
With DTI reconstruction, the volume and shape of your breast is restored immediately—you don’t have to wait for a later surgery. Because most mastectomies are skin-sparing, your own skin can usually be used to contain the implant, enhancing the appearance of the reconstructed breast. And having immediate reconstruction means there’s one less surgery for you to go through.
Timing of your implant procedures is an important consideration in breast reconstruction. If your implant reconstruction requires tissue expanders, implant placement will be delayed by several months.
You and your surgeon will also need to determine whether implants should be placed above the pectoral (chest wall) muscle or below it.
If you want to combine breast implants with a natural tissue procedure, you may be a candidate for hybrid reconstruction. And if you’re concerned about having to replace implants due to complications or aging, then a natural tissue procedure such as the DIEP flap may be a better choice.