51 year old with a strong family of breast cancer. She underwent bilateral prophylactic total skin and nipple areolar sparing mastectomies (preventative removal) and immediate reconstruction with tissue expanders and aceullar dermal matrix. She then underwent tissue expander implant exchange and autologous tissue fat grafting (fat transfer) to both breasts. Liposuction of the abdomen and flanks were performed to harvest the fatty tissue. She underwent an additional round of fat transfer 6 months later. She is shown 4 months after her final surgery and is very pleased with her final results. She has excellent symmetry with a pleasing, satisfactory shape.