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.
Due to the uncertainty of final breast volume, NAC reconstruction is a late stage of breast reconstruction. It's delayed until after breast mound reconstruction is completed, allowing for precise placement of the NAC by incorporating additional procedures such as fat grafting or excess tissue removal.