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*This 57 year old woman had a lumpectomy (partial removal of a breast) for a left sided breast cancer. After developing additional suspicious findings in the same breast at a later date, she and her general surgeon decided to complete the mastectomy. Her reconstructive surgical plan included a right breast reduction (SPAIR) so the same SPAIR reduction pattern was used for the left completion mastectomy and a tissue expander was put in place. Seven months later her tissue expander was removed and replaced with a smooth round 800 cc moderate profile silicone gel implant. A revision of her right breast reduction was done at the same time. Her reconstruction was completed one year later with reconstruction of her left nipple & areola, touch ups to the left reconstructed breast and correction of her right inverted nipple. Her surgical plan not only reconstructed her left breast but made her more comfortable by reducing the size of her breasts and correcting her breast asymmetry.