This 64-year old female previously had a right mastectomy for breast cancer. She also underwent multiple mammograms and biopsies on the left breast. She requested prophylactic left breast mastectomy and bilateral breast reconstruction. She underwent a nipple sparing mastectomy of the left and placement of ADM and tissue expander. She then had a right breast reconstruction with a Latissimus flap and tissue expander. She later had her expanders replaced with silicone implants and a right nipple reconstruction and tattoo.