Patient presented with unilateral breast cancer with plans for nipple-sparing mastectomy. She desired for prophylactic mastectomy and reconstruction on the contralateral side. After careful consideration, patient opted for implant-based breast reconstruction. She was not a candidate for autologous reconstruction and she wanted to have just one surgery, if possible. As such, she underwent single-stage breast reconstruction with bilateral nipple-sparing mastectomy, bilateral mastopexy and insertion of smooth round silicone implants in pre-pectoral plane. Patient was happy with the results. Often, single-stage implant-based reconstruction may not give you the best aesthetic results but it is a good option for patients who want reconstruction in the shortest amount of time as possible with shortest downtime. If desired, a revision can be performed to enhance the result, which can include fat graft, lift, and/or implant exchange.