Aesthetic aspects of breast reconstruction

Implant exposure, malposition, and capsular contracture, problems often seen with subcutaneous placement of implants in breast reconstruction, have been largely eliminated by submuscular placement of the implant. The pectoralis major, serratus anterior, rectus abdominus, and the latissimus dorsi are available as muscle and musculocutaneous flaps for coverage of implants in breast reconstruction. As symmetry is the goal in breast reconstruction, the shape and form of the opposite breast is taken into account in selecting a suitable flap for breast reconstruction. The roles and indications for each of these flaps in reconstruction of the breast are presented.