SCULPTING THE BREAST AND INSETTING
Shaping of the breast is done before and after the microsurgery is performed. There are many issues that are factors in the ultimate contour, and they include:
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The shape and possible need for further surgery on the other breast
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Skin sparing incisions
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Immediate reconstruction
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Delayed reconstruction
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Old scars
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Radiation
The most significant factor is the technical skill and artistic sense of the surgeons. Without those qualities, results can range from failure to an aesthetically displeasing outcome.
An abdominal skin island is present on the breast and can be variable in size. On the left below, is a typical island after skin sparing mastectomy. On the right, is a result reflective of the larger skin island resulting when delayed reconstruction is used. The nipple areola reconstruction is usually scheduled for a later date, when all tissue has healed. Secondary revision surgery may be required on the breast at a later date to improve appearance or symmetry.
