* This young wife and mother had a serious decision to make. She had a significant family history of breast cancer and had a breast biopsy that showed pre cancerous cells. She came to our office to discuss what reconstructive options she would have if she chose to have bilateral prophylactic mastectomies. With guidance from her surgeon she chose to have tissue expander breast reconstruction. The plan was as follows; her breast tissue would be scooped out from under the skin of her breasts using an incision in the fold under the breast. All of the skin of the breast would be preserved (including the nipple and areola). A temporary device called a tissue expander would replace the breast tissue. Enough fluid would be placed in the expanders to create some volume without putting undo pressure on the fresh incisions and mastectomy flaps. Three to four weeks after her initial procedure, fluid would be added to each expander in the surgeon’s office. This would be repeated two more times a few weeks apart. For this young woman everything went as planned. Five months after her initial procedure, she had an out-patient procedure where the tissue expanders were replaced with anatomically shaped silicone gel breast implants.