* This 29 year old woman had a very high family history of breast cancer and tested positive for the BRCA gene. She and her oncology surgeon decided that she should consider prophylactic mastectomies. She decided to go ahead with that plan and have immediate breast reconstruction at the same time. She had nipple & skin sparing mastectomies along with insertion of tissue expanders. Over the next few months fluid was added to the expanders. Four months after her initial surgery she had an out patient procedure in which the expanders were replaced with anatomically shaped gel breast implants. She wanted a larger breast than what she started with so 375cc implants were chosen. Fat grafting was done to the upper pole of her breasts as well to soften the contours. This result shows a very pretty breasts that look like she’s simply had a breast augmentation but for this young woman her risk of developing a breast cancer has been significantly reduced.