Pre-op: The circular incision of skin-sparing mastectomy	Four months post-op: Completed Peg flap reconstruction of the right breast

The Peg Procedures are novel concepts to analyze and perform surgery in a three-dimensional context.

Dr. Knowlton introduced the first Peg Procedures in a cover article of Contemporary Surgery in 1992. Both immediate and delayed Peg Procedures were presented in 1994 at the American Society of Plastic and Reconstructive Surgeons Annual Meeting, including the "Bowtie" nipple-areolar reconstruction.

Today, Dr. Knowlton is pleased to present a total system of breast reconstruction. The breast is divided into two aesthetic units: the breast mound and nipple-areolar complex. The contour of the breast mound is defined by the breast skin envelope and is most accurately reconstructed with techniques presented in the Peg I & II videotapes. In combination with a Peg flap, the bowtie technique can now create specific nipple-areolar contours. The specific contour of the nipple-areolar complex is determined by the geometry of the bowtie flaps and the direct closure of the donor site defects.

Please be advised that these pages contain graphic photos of surgical procedures.

• Volume I- Immediate Single Stage Reconstruction with Latissimus Dorsi Peg Flap
• Volume II- Immediate and Delayed Autologous Reconstruction with Latissimus Dorsi and Rectus Peg Flaps
• Volume III- The Pectoralis Peg with Bowtie