This healthy 49 year young mother of 3 children was noted to have a right breast cancer that was detected by mammogram. She elected a two stage expander/implant reconstruction. She underwent a right skin sparing mastectomy while performing a left breast risk reducing mastectomy but preserving the nipple. Five months later the expanders were replaced with Natrelle 410 shaped silicone gel implants, 335cc on the right and 310cc on the left to compensate for her breast and chest wall asymmetries. She has not yet determined if she will proceed with nipple reconstruction or tattooing. The patient is seen 8 months post op and is very happy with the outcome of her reconstruction surgery.