This patient was diagnosed with DCIS in her right breast spanning 18mm. She elected to have right breast lumpectomy with oncoplastic breast reconstruction and left breast symmetry procedure. 3 months later, patient had residual disease in her right breast and elected to have bilateral nipple and skin sparing mastectomies. She had tissue expanders and acellular dermal matrix placement bilaterally. After 4 months, her tissue expanders were exchanged with silicone implants and she had fat grafting to bilateral breasts.