62-year-old with history of left breast cancer treated with double mastectomy and tissue expander placement under the muscle, followed by chemotherapy. She had her initial surgery in a different city, and presented to Dr. Dumestre seeking completion of her reconstruction. She was unhappy with the shape, and animation from under the muscle expander placement. Photos: Before; 3 months after expander to implant exchange (390cc silicone implant) with change to above muscle position, repair of pec muscle. Now awaiting final surgery for fat transfer to both breasts.