Although flaps are made larger initially for this reason, it is hard to accurately predict the final breast volume. Because of this, NAC reconstruction is considered the very last stage of breast reconstruction, delayed until after breast mound reconstruction is completed (including additional procedures such as fat grafting or excess tissue removal) so that the positioning of the NAC can be planned precisely.
Because it's difficult to predict the final breast volume accurately, flap size is initially increased for this purpose. However, NAC reconstruction is considered the last stage of breast reconstruction and delayed until after breast mound reconstruction is finished (including procedures like fat grafting or excess tissue removal) so that the placement of the NAC can be precisely planned.