51 year old patient with right sided invasive lobular carcinoma who elected to have a bilateral skin sparing mastectomy with placement of tissue expanders and acellular dermal matrix (ADM) as a staged breast reconstruction at time of her bilateral mastectomy. Note that the first set of photos shows her before mastectomy and the after-photo shows after the second stage. In the next two set of photos, the before ones show during the tissue expansion phase and the after photos show after the second stage where the tissue expanders were exchanged to silicone gel 600cc high profile breast implants to give her current full projection and attractive cleavage. She achieved her desired 36 full D cup, a size upgrade from her pre op 36 C, with this final breast implant reconstruction outcome. She did not elect to have new nipples made or tattooing.