This 41-year old female underwent mastectomy for left breast cancer.  When her cancer treatments were completed she was interested in a left breast reconstruction as she was tired of wearing  a prosthesis.  She underwent a staged reconstruction, with Latissimus flap and tissue expander placement.  After her tissue expansion she had her permanent implant placed.  She then completed her reconstruction with a right breast mastopexy for symmetry and left nipple reconstruction with a free nipple graft and nipple tattoo.