This is a 65 year old female who is 5 feet 7 inches and weighed 160 at the time of her surgery. She was diagnosed with right breast cancer and elected for bilateral mastectomies with placement of tissue expander to implant based breast reconstruction at an outside facility. She then elected for removal of her implants. She presented after her mastectomies and underwent bilateral placement of tissue expanders and acellular dermal matrix. She then elected for removal of tissue expanders, capsulectomies with placement of smooth, round saline implants with autologous fat grafting to her infraclavicular hollows. She then later elected for bilateral 3D nipple/areola reconstruction.