This woman in her 50's presented 9 years after inital breast augmentation with saline implants, who sustained spontaneous deflation of the left implant. She desired implant exchange to silicone and a bit of a larger size. On preoperative evaluation she was found to have a concerning mammogram. She was diagnosed with early breast cancer of the right breast, close to her nipple. She therefore underwent right mastectomy, and immediate reconstruction with latissimus back tissue and implant. At that time the left deflated saline implant was removed and replaced with a larger silicone implant. She ultimately underwent right sided nipple reconstruction. She is photographed 14 months after her initial surgery. She has done great and loves her aesthetic outcome!