TRAM Revisions and Contralateral Mammaplasties: The Role of "Mirror Image" Skin Patterns.

Symmetry is the sine qua non of breast reconstruction. A symmetrical result offers peace of mind, a healthy body image, and improved self-esteem to the patient and presents a sometimes elusive goal to the plastic surgeon. When symmetry comes with modest effort we are pleased, but more often the effort is prolonged through several operations over a period of time. This article addresses the management of both the reconstructed breast mound(s) as well as the contralateral breast at different stages of the reconstruction process. By approaching the reconstructed breast mound(s) and a remaining native breast as similar soft tissue structures with similar soft tissue envelopes, it may be possible to maximize the symmetry of the final result.