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Figure 3: 40-year-old lady with left breast cancer (Case 2). (a) Pre-op photograph with skin mark showing the site of cancer in upper outer quadrant of left breast. She has bilateral pseudoptosis. She smoked (1-2 per day) at presentation. (b) Immediate post-op after left NSMx and implant reconstruction. She developed superficial skin necrosis of the skin flap on the inferior aspect that was managed conservatively. The nipple shaves on left side were positive for DCIS. She underwent nipple excision under local anesthetic. (c) The left breast reconstruction after nipple excision. (d) Post-op photograph after right risk-reducing NSMx with one-stage implant reconstruction, 15 months after the surgery on left side. There is a degree of capsular contracture on left side due to radiotherapy.