This patient is a 69 y/o found to have left invasive lobular carcinoma. She underwent bilateral mastectomies, followed by an immediate bilateral DIEP breast flap reconstruction. The patient had a previous nephrectomy with a large scar on her left abdomen, therefore the abdominal incision from her DIEP was higher than normal to remove the old scar. She did not desire any revisional surgeries, therefore her reconstruction was a single stage procedure. She completed her reconstruction with 3D nipple tattooing.