This patient developed right breast cancer. She completed neoadjuvant chemotherapy prior to undergoing bilateral mastectomies via curvilinear ellipses to remove some extra skin and provide a subtle breast lift. She had immediate subpectoral tissue expander and Alloderm reconstruction. She is shown here 3 months afterwards at the completion of her radiation therapy. Note the intense skin reaction that is typical but will fade with time. She will undergo exchange to highly cohesive (gummy bear) silicone implants 6 months after her radiation completion to allow appropriate tissue recovery from the radiation therapy.