50 year old who underwent left total mastectomy and tissue expander reconstruction for breast cancer. She was displeased with her left breast shape and the symmetry between her breasts. Revision was performed in stages. A new tissue expander was placed on the left side and additional expansion was performed. At a second surgery the tissue expander was removed, and pocket revision, implant placement, and fat transfer was performed. A right breast lift and reduction was also performed at this time for symmetry. She also underwent concurrent abdominal wall hernia repair and full tummy tuck. She is shown 6 months after surgery and is very pleased with her results. She will undergo left nipple reconstruction at a later date.