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Breast cancer surgery has evolved. The goals not only successfully treat cancer, but also minimize deformity. Oncoplastic lumpectomy reconstruction delivers excellent treatment and improves aesthetics with equal survival to mastectomy. Some patients choose mastectomy or require mastectomy after lumpectomy and radiation for a recurrence. 1,6 Patients who test positive for genetic mutations proceed with bilateral mastectomy to confer a survival benefit. 2 For these women, autologous breast reconstruction is gaining popularity. 3 Plastic and reconstructive surgeons and oncologic surgeons need to continue optimizing mastectomy outcome. Factors such as previous radiation, multiple incisions, and protein deficiencies, in combination with an inherent "devascularizing" operation, impair mastectomy healing. In our daily practice, and through tumor board discussion, close communication among breast surgeons, breast radiologists, and plastic surgeons facilitates a plan for autologous reconstruction that optimizes

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