This 61 year old woman was diagnosed with left breast cancer. She chose double mastectomy with tissue expander reconstruction, along with dermal autologous flaps to utilize the excess skin of the breast for additional volume and shape. She desired a reduction in size. Her pre-op pictures show her before surgery. The intermediate photos show her expanders in place, fully inflated, about 6 months later. Note the shape with expanders is often not the final desired shape, as illustrated in the post op photos shown an additional 2 months later. Her post op pictures show her after placement of Mentor Ultra High Profile silicone gel implants, Left 800cc, Right 750cc; also shown is nipple reconstruction with CV flaps and areolar tattoo. The post op pictures are shown 8 months after her mastectomy.