Over the years, although methods of breast reconstruction have improve
d, the ability to build a symmetrical projecting breast has not. When
stacked Meme implants were used, better projection was obtained. Foldi
ng the transverse rectus abdominis musculocutaneous flaps allows for g
ood projection; however, the breast is then quite wide and large. For
smaller breasted women with projection and some larger breasted women
as well, splitting and stacked flaps give a much better result. We now
do this procedure with simultaneous Latram and mastectomy surgery in
fewer than 3 hours.