Some surgeons prefer to design the areolar opening at the end of the procedure. It doesn't matter. Surgeons should adapt their current design to the vertical technique using whatever approach they find more comfortable. Wise's original design  incorporated a 14-cm circumference for the areola (about a 4.5-cm-diameter areola), and I just adapted what I learned to the vertical technique. I prefer a 5-cm-diameter areola that matches a 16-cm circumference.
Madeline Lejour adapts a mosque pattern to the areolar opening, but I would rather take more distance vertically than horizontally. Carolyn Kerrigan takes a circle in a silicone sheet and opens it out to meet the vertical limbs. As long as the final pattern results in a circular opening, the actual design is irrelevant.
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This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.