Three months after double incision mastectomies and free nipple reconstruction.  Scars fading with use of silicone sheeting.  This is a patient who might have considered a keyhole or peri approach but most likely would have had loose skin and contour irregularities requiring significant secondary surgery at a later date.  The double incision technique  has produced an excellent contour right from the start.  Scars should continue to fade through one year.