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Breast reconstruction following mastectomy can be challenging for both the patient and surgeon. Breast reconstruction can be performed immediately following mastectomy or can be performed in a delayed fashion where a patient undergoes a mastectomy in one procedure and then implant or autologous tissue reconstruction in another procedure.

I typically educate patients who undergo reconstruction with tissue expanders or implants that these procedures are frequently performed in stages. Often, the first stage of reconstruction requires the placement of a tissue expander, followed by a second procedure where implants are placed and a final symmetry procedure is performed.

I have found great utility in the use of the neo-supracapsular pocket to control and reposition the inframammary fold in breast reconstruction. I find that the surgeon can have excellent control of the fold position without any untoward puckers or dimpling. One of the goals in breast reconstruction following mastectomy is to have the patient feel comfortable and confident in clothing and/or in a bra.

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