This technique was first introduced by Josie Todd in the South Island for medium-breasted women with moderate-sized cancer without the need for a formal mastectomy. This is a more extensive operation involving bilateral surgery and a slightly longer recovery period (approximately 6 weeks) compared to a simple WLE. The main advantage of this procedure is that it avoids poor cosmetic outcomes and asymmetry in patients compared to a simple WLE. All patients must have a formal clinical assessment to determine suitability for this technique.