* This 40 year old woman had bilateral nipple sparing mastectomies for breast cancer. At the same time she had tissue expander and acellular dermal matrix breast reconstruction. Fluid was added gradually to her tissue expanders over the next few months. Then they were replaced with anatomically shaped silicone gel breast implants. Fat grafting was added to the superior aspect of each breast to soften the contours of the breasts. Her post operative photos show her at 6 months following her second surgery.