Fifty year-old female who underwent left breast reconstruction with a tissue expander which was subsequently radiated and exchanged to a saline implant along with augmentation mastopexy to the contralateral breast by another surgeon. She developed a capsular contracture with severe pain, tightness and hardening of the reconstructed breast. She underwent removal of the implant, capsulectomy and left DIEP flap reconstruction. This was followed by nipple reconstruction and fat grafting. The post-operative photos were taken 10 months after her most recent procedure.