This 43-year-old female from Escondido, CA underwent bilateral cosmetic breast augmentation with 550 cc saline implants several years ago by another plastic surgeon. She is now diagnosed with right breast cancer and had positive margins following lumpectomy. She was therefore scheduled for right mastectomy and elected to undergo prophylactic left mastectomy as well. She was interested in bilateral immediate breast reconstruction and Dr. Gupta was therefore consulted given the complexity of the case. Dr. Gupta removed both saline implants during the mastectomy and then performed bilateral tissue expander and Alloderm reconstruction. After complete tissue expansion to the patient's desired breast size, Dr. Gupta performed second stage breast reconstruction with 650 cc silicone gel implants. These pictures were taken 4 months after surgery. The patient is very happy with her results and will now proceed with nipple reconstruction.