The procedure that’s right for you has a lot to do with the amount of extra skin and chest tissue (your soon-to-be former breast) you have. Patients with minimal skin and tissue can do well with a keyhole incision approach, with no skin removal, while other patients with more skin require a purse-string (circumareolar / periareolar / purse-string) or fishmouth / extended wedge approach. More skin & more tissue means that you will really be only a good candidate for a double-incision or inverted T mastectomy. These are procedures where maximal skin can be removed.