Managing the opposite breast: contralateral symmetry procedures

The importance of symmetry after unilateral breast reconstruction is becoming increasingly realized and important. As our reconstructive options have increased and our technical abilities have improved, the expectations of women with breast cancer have been enhanced by virtue of the fact that we are often able to reconstruct a breast with natural volume and contour. When embarking on a unilateral breast reconstruction, the plastic surgeon has several goals and one of which is to obtain breast symmetry. In many circumstances, breast symmetry is achieved without operating on the contralateral breast; however, in some cases, a contralateral operation will be necessary. This is usually based on the volume, contour, and position of the natural and reconstructed breast. Often, the need and/or desire for a contralateral procedure will be evident during the initial consultation. Otherwise, the need for a contralateral procedure will not be evident until after the primary reconstruction has been completed. In either case, it is important for plastic surgeons to be aware of the incidence of these procedures and the options available to them.