Excellent results from TRAM flap reconstruction depend on proper patie
nt selection and proper surgical planning and execution. It is difficu
lt to achieve perfection and completion of the reconstruction in a sin
gle operative procedure. The second stage gives the surgeon an excelle
nt opportunity to not only perform the nipple-areola reconstruction bu
t also to enhance the quality of the initial procedure and give the pa
tient the best possible result as well.