38 yo with BRCA1 gene, presenting to me 'flat', after undergoing preventative double mastectomy and immediate tissue expander reconstruction, which had to be removed twice due to infection in a different city. Planned 3-stage reconstruction to restore her breasts. First surgery was just fat transfer to the chest wall to thicken her skin, 2nd surgery involved placement of tissue expanders to re-stretch the skin, and finally 3rd surgery was expander to implant exchange with fat transfer. Photos: Before; and 3 months after final surgery (480 moderate plus projection silicone implants)