37 yo who noticed a lump in her left breast. Biopsy proved an invasive malignancy and the patient elected to have chemotherapy and a left mastectomy and prophylactic right mastectomy. Breast reconstruction was performed at the same time with bilateral muscle sparing free TRAM flaps. Six months later nipple areolar reconstruction was performed. The patient does not wish to have tattooing of the nipple areolar complex. Postoperative photographs are taken 3 years following her mastectomies.