This 43-year-old woman underwent bilateral mastectomy for DCIS. She had nipple-sparing mastectomies performed followed by immediate implant breast reconstruction by Dr. Andres. After discussion of all of the various options with the patient, she was deemed to be an excellent candidate for direct to implant breast reconstruction as a single-stage procedure. Postoperative views at 1.5 years demonstrate a very pleasing breast reconstruction. Performance of the nipple-sparing mastectomy and immediate reconstruction is done by very few surgeons, but as demonstrated, could produce excellent size, symmetry, and shape of reconstructed breasts that endures over time. She is very content with her new reconstructed breasts, which was performed as a single-stage procedure, with little recuperation and downtime.