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.