This patient had pre-existing breast asymmetries and tightness. She developed left breast cancer and hoped to be more full and symmetric after her reconstruction. She underwent bilateral skin sparing mastectomies through horizontal ellipse incisions and immediate prepectoral (on top of the muscle) reconstruction with expanders by Dr. Geiger. The tissues were stretched as she completed chemotherapy. She later underwent exchange to the latest generation, highly cohesive (gummy bear) smooth round silicone implants (750cc SCX left, 700cc SCX right) prior to her radiation treatments. Here she is 9 months after radiation with added fullness and a great appearance in addition to treatment of her cancer.