* This 39 year old woman was diagnosed with breast cancer. She decided to proceed with bilateral nipple sparing mastectomies and immediate breast reconstruction. She met with her reconstructive surgeon to discuss options in breast reconstruction. After a lengthy discussion the decision was made to have tissue expanders put in place after her mastectomies. Five months later her expanders were replaced with smooth round gel implants. Fat grafting was done at a later time to soften the contours of the breasts. When it was all said and done she had a beautiful breast reconstruction that looked like she had had a cosmetic breast augmentation along with a breast lift. Her photos show her two years after her final procedure.