Patient presented with unilateral breast cancer with plans for nipple-sparing mastectomy. Patient previously had breast augmentation and wanted to be slightly bigger. 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.