Following mastectomy, breast reconstruction can be performed with tissue expanders and implants or with autologous tissue. Typically patients who do not need radiation can be reconstructed with either option. In the ptotic breast, the Wise skin pattern or inverted-T pattern allows the breast to have a less ptotic or more youthful appearance.
I find that when using a Wise pattern or inverted-T pattern it is better to under fill the expander during the initial placement. Once the wounds are appropriately healed, the expander can be filled and eventual transition to implant.