The sit-up position for breast reconstruction.

For breast reconstruction, we have found that breast symmetry can be created optimally when the patient is brought to a totally upright position with the trunk vertical and perpendicular to the floor. The size of the opposite breast can better be appreciated. Nipple and areola position can be determined accurately even with the patient asleep if she is brought to the upright position. The safety of the upright positioning is documented in our series but depends on planning with the anesthesiologist preoperatively and allowing time to move the patient cautiously. An anesthesia technique for intraoperative vertical positioning is reported.