A nipple-sparing, skin-reducing mastectomy was performed with the blood supply for the nipple-areola complex based on the superior pedicle (Fig. 50.2a). The weight of the resection specimen was 730 g. The insertions of the pectoralis major muscle were dissected off the thoracic wall, and a 330 cc anatomical implant was placed under the muscle and covered with a de-epithelialized dermoglandular flap (Fig. 50.2b–d). The skin was closed with an inverted T scar. Two drains were used. Sentinel lymph node biopsy was done through an axillary incision and revealed four negative lymph nodes.