This patient presented with complaints about her implant reconstruction including contour irregularities, abnormal nipple position, and feeling too large. Her abdomen had been liposuctioned for fat grafting, also resulting in a hollow appearance. In this case, a staged operation was performed. Implants were first removed and exchanged to tissue expanders and an abdominal delay procedure was performed to enhance the vascularity of planned DIEP flaps. Flaps were then transferred and the breast reconstructed using a hybrid approach, combining a DIEP flap with implant. Final revisions were later performed for best final contour.