"For older women undergoing mastectomy for breast cancer directtoimplant DTI breast reconstruction provides good outcomes in a singlestep procedure httpsjournals.lww.complasreconsurgFulltextDirect_to_Implant_Breast_Reconstruction_in_Women..aspxPRIDPRS_PR_DTI_ while avoiding some of the inconvenience and risks of staged approaches to breast reconstruction reports a study in the February issue of Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg the official medical journal of the American Society of Plastic Surgeons http ASPS.  The DTI approach is a powerful tool for breast reconstruction in elderly patients comments ASPS Member Surgeon Andrea Moreira MD of the Cleveland Clinic. The researchers believe the DTI technique may expand the options for older women who are less likely to undergo breast reconstruction. Good Results with DTI Breast Reconstruction in Women over   Directtoimplant breast reconstruction has emerged as a singlestage approach to immediate breast reconstruction after mastectomy. So far however most studies of DTI have focused on younger women. Half of all breast cancers occur in women over  yet only four to  percent of these women undergo reconstruction Dr. Moreira and coauthors write. Most studies of breast reconstruction in older women have focused on multiplestep techniques such as tissue expander implant TEI reconstruction. The researchers identified women over age  who underwent DTI reconstruction at the Cleveland Clinic between  and . They identified a total of  breasts reconstructed by DTI in  patients all with at least  days followup and most with one year of followup Patient characteristics and outcomes were compared to those of  breasts with TEI reconstruction in  patients. The women undergoing DTI reconstruction were older . versus . years and had a higher body mass index compared to the TEI group. Both DTI and TEI were safe and effective options for breast reconstruction. Complication rates were similar between groups including blood and fluid collections hematoma and seroma infection unplanned surgery and failed reconstruction.  However DTI had some important advantages. Women in the DTI group were less likely to be readmitted to the hospital and spent fewer total days in the hospital. In the year after surgery was completed women in the DTI group made an average of . office visits compared to about  visits in the TEI group. The DTI group also spent fewer days with a surgical drain in place average about  days compared to  days in the and had fewer total days in the hospital. Thats an important consideration as drains require antibiotic treatment to prevent infection in addition to causing discomfort for the patient. The authors note some important limitations of their studyparticularly the fact that it was a review study of one hospitals experience with a relatively new procedure. Dr. Moreira and colleagues write These reported cases include our learning curve patients as we familiarized ourselves with appropriate patient selection and surgical technique.  The researchers emphasize that DTI isnt an option for every patient depending on breast shape and other factors. Despite these limitations their experience suggests that complications of the DTI approach in older women are similar to those of the more commonly used TEI technique. Dr. Moreira adds In appropriately selected cases DTI reconstruction is a viable alternative to staged techniques requiring multiple surgeries.  Plastic and Reconstructive Surgery httpjournals.lww.complasreconsurg is published by Wolters Kluwer. Click here to read DirecttoImplant Breast Reconstruction in Women Older than  Years A Retrospective Analysis of Complication Rate and Overall Outcomes. httpsjournals.lww.complasreconsurgFulltextDirect_to_Implant_Breast_Reconstruction_in_Women..aspxPRIDPRS_PR_DTI_ DOI .PRS. About Plastic and Reconstructive Surgery  For more than  years Plastic and Reconstructive Surgery http has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons Plastic and Reconstructive Surgery brings subscribers uptotheminute reports on the latest techniques and followup for all areas of plastic and reconstructive surgery including breast reconstruction experimental studies maxillofacial reconstruction hand and microsurgery burn repair and cosmetic surgery as well as news on medicolegal issues. About ASPS  The American Society of Plastic Surgeons http is the largest organization of boardcertified plastic surgeons in the world. Representing more than  physician members the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than  percent of all boardcertified plastic surgeons in the United States. Founded in  the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. About Wolters Kluwer  Wolters Kluwer N.V. AEX WKL is a global leader in information services and solutions for professionals in the health tax and accounting risk and compliance finance and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services. Wolters Kluwer reported  annual revenues of . billion. 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