This patient developed left breast cancer. She completed chemotherapy prior to undergoing bilateral skin sparing mastectomies through horizontal ellipse incisions. She had immediate prepectoral (on top of the muscle) reconstruction with tissue expanders. The tissues were stretched to her final size before she then completed a course of radiation therapy to the left breast. 6 months later she recovered enough to complete her reconstruction with exchange to the latest generation, highly cohesive (gummy bear) smooth round silicone implants (750cc SCX right; 800cc SCX left). Dr. Geiger will often use a larger implant on the radiated side as there tends to be ongoing contracture and shrinking to the radiated breast with time. Here she is looking great and recovering well from all of her treatments.