This patient was diagnosed with left breast cancer and underwent immediate pre-pectoral placement of tissue expanders. Given a close tumor margin to the skin, she was recommended for radiation after her mastectomy. Once radiation was completed, she chose autologous reconstruction with DIEP flaps from the abdomen. This method of reconstruction is known as “immediate-delay,” in which a tissue expander is placed at the time of mastectomy to preserve the natural breast footprint and 3-dimensional shape. Once the skin recovers from radiation, the expander is removed and replaced with the patient’s own natural tissue. The natural tissue (DIEP flap) brings a healthy new blood supply to the skin, improving damaging effects of radiation.