* This 59 year old woman had bilateral mastectomies for early breast cancer. She had total skin sparing mastectomies (leaving all of the skin of her breasts) through inframmary fold incisions. Immediate breast reconstruction was done using anatomically shaped tissue expanders. They were partially filled at the original procedure and then filled twice in the office. Four months later the tissue expanders were replaced with anatomically shaped gel breast implants with a moderate profile and height and 495cc volume. She now has a very pretty breast reconstruction completed with a simple and mildly invasive reconstructive plan.