This 77 year old woman had undergone right mastectomy and reconstruction over thirty years prior with a silicone implant. She underwent a two stage revision with removal of her old implant and scar tissue (“capsulectomy”) and insertion of a tissue expander. This was followed 5 weeks later by removal of her expander and placement of a silicone gel filled implant, along with a left unilateral mastopexy (breast lift). She is seen one year after her surgery. She declined to have right nipple areola tattooing.