This 51 year old woman was diagnosed with a stage II right breast carcinoma. Her general surgeon recommended a right nipple sparing therapeutic mastectomy and a left prophylactic nipple sparing mastectomy because of an unfavorable family history as well as the patient having had multiple previous biopsies for suspicious fibroglandular cysts and lumps. Her incisions were placed in the inframammary fold (underneath the breast). She underwent initial placement of tissue expanders with Acellular Dermal Matrix and subsequent second stage conversion to permanent smooth round high profile silicone gel implants two months later. She is seen three months after her second stage surgery.