Women with previous submuscular breast augmentation who contract breast cancer have several options for breast reconstruction. Our institution offers implant-sparing mastectomy with delayed implant exchange. A retrospective review of 10 patients who underwent implant-sparing mastectomies with delayed implant exchange between 2006 and 2010 was performed. The average age at implant exchange was 48.7 years. The average time between initial augmentation and mastectomy was 7.45 years. The average time between mastectomy and implant exchange was 7.1 months. One patient underwent partial mastectomy with radiation. The average size of implant at initial augmentation was 366 mL. The average size of implant exchange on side of mastectomy was 565.5 mL. One patient underwent a second exchange for larger implants. No other complications were noted. Implant-sparing mastectomy with delayed exchange provides an alternative to tissue expander placement and associated morbidities. This technique provides excellent results with minimal complications for this patient population.