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Reverse fish-tail design for correction of lateral fullness following mastectomy and DIEAP reconstruction.

DISCUSSION Our simple modification of the classic transposition flap design eliminated the formation of a dog ear. The use of a curvilinear incision by leaving more skin behind reduces flap/wound length discrepancy and reduces the apical angle. Though this appears counter-intuitive, we have demonstrated how this technique can be applied. While dog ears can settle over time, we encourage reconstructive surgeons to consider the use of our modification to optimise cosmetic outcome.