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This patient underwent staged reconstruction for genetic high risk of breast cancer. She had a pre-existing tuberous breast deformity resultant in constriction of the natural width of the breast and abnormal nipple position. To correct the deformity and reconstruct the breast, she underwent breast lift followed by mastectomy and tissue expander reconstruction to upsize the breast volume which she desired. She then underwent pre-pectoral implant placement and final fat grafting for contour.

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