The more excess tissue you have in the breast area, the more time and specialized surgical skill is required to achieve an optimal aesthetic result. While there is no guarantee you won't need a revision, it is absolutely possible and reasonable to ask that your cancer surgeon either do this contouring work themselves OR bring on a plastic surgeon to do it, at the initial surgery. Note that plastics closure is not standard practice right now - but we hope that will change as more patients push for better aesthetic consideration. Also, Goldilocks may be an option for you.