56 yo. She had bilateral mastectomy without reconstruction. She came to see me later wanting bilateral DIEP flaps. These were done. She did not have a lot of abdominal fat, so after the DIEP flap surgery and waiting 4 months, silicone breast implants were placed under the DIEP flaps to give her a more projected overall result. There is a slight risk of flap loss when this is done but she did great! The after picture is taken two months after the implants were placed.