49 yo with invasive ductal carcinoma and ductal carcinoma in situ of the left breast. The patient also positive for genetic mutation BRCA2 and therefore elected to have bilateral mastectomies. She underwent immediate reconstruction with bilateral DIEP microvascular free flaps. One year late she underwent nipple reconstruction and tattooing. Photos taken 3 years alter. She underwent further tattooing to camouflage the surgical areas.