This patient is a lovely 44?year?old female with a history of bilateral mastectomies with a severely complicated post operative course by other surgeons with loss of her reconstruction on the Right and a large ptotic breast on the left. We were able to perform a complete complex reconstruction to rebuild her Right chest wall with a Direct-to-Implant Right breast reconstruction and a mastopexy to create symmetry on the Left breast. She is overjoyed that she now has two breasts that match and fit into her clothing well.