A young patient with breast cancer and previous saline implant underwent a right nipple-sparing mastectomy (NSM) with sentinel node biopsy (SNB), opposite total mastectomy, and tissue expander/ADM reconstruction. Our Nashville plastic surgeon achieved positive results for the immediate nipple sparing breast reconstruction using 410 (gummy gear) implants, ADM, and fat grafting. The incision on her left chest was for port placement for chemotherapy. Right 410-560cc. Left 410-560cc.