40-year-old diagnosed with left breast cancer, planned treatment chemotherapy followed by double mastectomy. Due to unknown need for post-mastectomy radiation, opted to proceed with tissue expander reconstruction before DIEP flap. Photos: Before; 3 months after double nipple-sparing mastectomy and immediate tissue expander placement; 2 months after tissue expander removal and DIEP flap reconstruction. Fortunately she did not end up needing radiation therapy.