* This 47 year old woman had bilateral breast cancer. She had bilateral skin sparing mastectomies and immediate tissue expander breast reconstruction. Fluid was added to her tissue expanders gradually and 6 months later her expanders were replaced with 800cc smooth round gel implants with a moderate plus profile. Fat grafting was also done to smooth out the upper pole of her breasts. Four months later her nipple and areola complexes were reconstructed giving her a very natural looking breast reconstruction.