47 year old female with a strong family history of breast cancer was diagnosed with a right sided breast cancer, 6mm invasive ductal. She was 5’3″”, 110 pounds, 32 A cup originally. A lumpectomy was done which revealed extensive DCIS. She then underwent bilateral nipple areola sparing mastectomies with immediate reconstruction. Reconstruction was done in one stage with Mentor smooth round moderate profile 225 cc permanent silicone implants and acellular dermal matrix.