Figure 2.

Patient positioning and preoperative marking. Patients are marked in an upright position prior to going to the OR. Markings should include normal anatomic boundaries and account for how an enlarged breast from an effusion may need to be reshaped for symmetry. Explantation without reimplantation may require a concomitant mastopexy to account for excess skin redundancy. (A) The decision to perform a mastopexy is based on the skin laxity, here demonstrated in a 64-year-old woman. (B) In rare situations, a BIA-ALCL mass may be near or invade overlying skin (red circle). In these cases where skin excision is required, a Wise-pattern type skin excision or modification can be employed to account for the skin loss while still maintaining the tear-drop shape of the breast.