Two-stage implant based breast reconstruction: should we always exchange the tissue expander for an implant right away?

Two-stage implant based breast reconstruction (IBBR) accounts for more than 70% of reconstructions after any type of mastectomy in US in the year 2014 (1). As for reconstruction after nipple sparing mastectomy (NSM), a single-institution retrospective series on 482 cases [2007–2012] shows that direct-to-implant (DTI) reconstructions are 59.3%, tissue expander (TE)/two-stage 38.4% and autologous flaps 2.3% (2).