Fig. 2. Tailored mammaplasty along the breast transverse axis.

An artist's drawing illustrates the transverse axis of the right breast during one-stage immediate breast reconstruction after nipple-sparing mastectomy. Notice that the breast conus (parenchyma) is completely replaced by the definitive anatomic implant that provides the shape and projection of the reconstructed breast. The conical projection of the healthy breast is lost. The implant-to-breast transition is rough, consisting of the implant covered by the pectoralis major, a thin layer of subcutis, and skin. A smaller, low-projected implant has been placed in a dual-plane pocket to provide prosthetic imprinting to the contralateral breast. However, despite using the smallest implant possible, the augmentation mammaplasty alone cannot properly symmetrize the breast. The removal of the base of the breast (shown in pink), the resection of the lateral quadrants (shown in blue), and the removal of the circumareolar skin (shown in green) are the steps of tailored reduction designed to properly symmetrize the breast by flattening the breast and nipple-areola complex and symmetrizing the base of the breast.