October 2025
Direct-to-implant (DTI) breast reconstruction often uses soft tissue support to improve outcomes and reduce implant migration.
Why this matters
Direct-to-implant (DTI) breast reconstruction often uses soft tissue support to improve outcomes and reduce implant migration. This work contributes to evidence-based plastic and reconstructive surgery — helping clinicians interpret outcomes, refine technique, and counsel patients with clearer data.
Author
Plastic and reconstructive surgery resident at Emory University (UCLA BS, USC MD) with an h-index of 15 and peer-reviewed work spanning aesthetic surgery, reconstruction, medical devices, and AI in medicine.
Abstract
Direct-to-implant (DTI) breast reconstruction often uses soft tissue support to improve outcomes and reduce implant migration. Synthetic meshes, such as TIGR Matrix, have emerged as potential alternatives to biological materials due to lower costs and complication rates. This study reviewed early outcomes using TIGR Matrix in immediate DTI reconstruction. A retrospective chart review was conducted on patients who underwent implant-based reconstruction with TIGR Matrix between November 2023 and June 2024 across 2 institutions. Inclusion criteria included DTI reconstruction with at least 6 months of follow-up. Data collected included demographics, oncological and reconstructive details, comorbidities, and postoperative complications. Statistical analysis was performed using MATLAB with t tests and χ2 tests. Seventy-one patients (109 breasts) met inclusion criteria. The cohort included 42.2% nipple-sparing, 40.4% skin-sparing, and 11.0% Goldilocks mastectomies. The mean patient age was 52 years. The mean time to first postoperative follow-up was 8.3 days. Major complications included 6 hematomas (5.5%), 3 seromas (2.8%), 2 infections (1.8%), and 3 explantations (2.8%). Eleven (10.1%) patients required reoperation due to complications including infection, necrosis, or residual disease. Minor complications (delayed wound healing, eschar) were observed in 17.4% of breasts. The overall complication rate excluding minor events was 12.8%. TIGR Matrix demonstrates an acceptable early complication profile in DTI breast reconstruction and may serve as a cost-effective alternative to acellular dermal matrices. Additional studies are needed to assess long-term outcomes and comparative effectiveness.