This 50 year old woman was diagnosed with right breast cancer. She chose bilateral mastectomy along with immediate breast reconstruction using tissue expanders. She required post-operative radiation to the right breast. The intermediate photos are shown after radiation completion and after the expanders were replaced with silicone implants, Mentor High Profile 275cc each. The post-operative photos are shown at 2 year follow-up, with completion of nipple reconstruction using local skin flaps and areolar tattoos.